Thursday, February 11, 2021
Category: Bacterial Infections, Pharmacotherapy
Dr Amanda Mercurio, ID clinical pharmacist at the James A Haley Veterans Hospital, discusses the latest guidelines regarding the dosing and therapeutic drug monitoring of aminoglycosides and vancomycin. Dr. Mercurio begins by identifying the pharmacokinetic parameters for dosing antibiotic medications. She reviews the concepts of steady state and loading doses. She distinguishes between concentration dependent, AUC dependent, and time dependent dosing. She then discusses the unique pharmacokinetic parameters for aminoglycosides, including the benefits of extended interval dosing. Dr. Mercurio then goes through a step-by-step process for calculating aminoglycoside dosing based upon preferred nomograms. Next, Dr. Mercurio moves on to Vancomycin therapeutic modeling. In particular, she discusses the differences between older peak and trough-based dosing with the newer recommendations to dose based upon AUC modeling. Dr. Mercurio closes by going through a case-based example of dosing using the new guidelines.
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