Vancomycin AUC values estimated with trough-only data: Accuracy in an adult academic medical center population.

Purpose: Vancomycin area under the concentration-time curve (AUC) can be calculated using steady-state serum peak and trough concentrations; however, compared to traditional trough-only monitoring, this approach requires an additional blood sample. Recently published data demonstrated vancomycin AUC estimations using trough-only data with a volume of distribution (Vd) model incorporating age and actual body weight were reasonably accurate and precise in a veteran population. This study sought to extend these methods to a Mayo Clinic adult population.

Accuracy of vancomycin AUC values estimated with trough-only data in a veteran population.

Purpose: The purpose of this study was to evaluate the accuracy and precision of estimating area under the curve (AUC) values using only vancomycin trough concentrations versus both peak and trough values derived from applying 4 different volume of distribution (Vd) models in a veteran population.

Methods: This retrospective, observational study was performed from July 2021 to April 2022 using data from 5 Veterans Affairs hospitals across the US. AUC values for a total of 259 veterans were included in the analysis, with 10 excluded after pooling of data.

Vancomycin area under the curves estimated with pharmacokinetic equations using trough-only data.

What Is Known And Objective: The revised vancomycin monitoring guidelines recommend targeting an area under the curve (AUC) of 400-600 mg*hr/L for serious methicillin-resistant Staphylococcus aureus (MRSA) infections. An AUC can be measured by checking a peak and trough concentration at steady state; however, this requires obtaining an additional blood sample. The most practical way to perform AUC-guided dosing is by estimating an AUC from a steady-state trough.

Initiation of direct oral anticoagulants versus warfarin for venous thromboembolism: impact on time to hospital discharge.

The objective of this project was to compare the time from initiation of oral anticoagulation to hospital discharge between warfarin and direct oral anticoagulants (DOACs) for the treatment of acute venous thromboembolism (VTE). This retrospective observational study was done at a single VA medical center. A total of 107 patients were included, with 42 patients (39%) in the DOAC group, which included rivaroxaban, dabigatran, and apixaban, and 65 patients (61%) in the warfarin group.

A Comparison Between Dabigatran and Warfarin on Time to Elective Cardioversion.

Objective: To evaluate the use of dabigatran versus warfarin on time to elective direct current cardioversion (DCCV).

Methodology: This retrospective observational study was conducted at a single Veterans Affairs hospital in the Southwestern region of the U.S.

Evaluation of initial heparin infusion rates for a high-dose protocol.

Unfractionated heparin is widely used as anticoagulant therapy for thrombotic disease. However, determining appropriate dosing by intravenous infusion is highly variable in practice. Multiple standardized protocols have been adopted, including a weight-based nomogram entailing a loading dose of 80 U/kg, followed by an initial infusion rate of 18 U/kg/h.