A few weeks ago I posted on Vancomycin and the Nephrocidal Maniacs – in that post I described the problems that we have in the Kimberley with MRSA, renal disease and sepsis. We walk a fine line between toxicity and efficacy when we treat our patients with severe, limb-threatening infections.
I have learned a lot about the rational prescribing of vancomycin in the last few years and have read literally hundreds of papers on the topic. In true “Broome Docs” style I have dived deep down the rabbit hole of pharmacological, microbiological and clinical literature to bring you what I think is a ‘better way’ to use vancomycin in small, rural hospitals.
The result of all of this pondering is a new protocol which I have been using on selected patients in recent months to try and enhance the safety, avoid toxicity and get them better faster.
Have a look at the diagram [highly technical…] below to help you visualise the pharmacokinetics. Also, have a read through the draft protocol that I have developed and stolen from all the best sources that I could find across the academic ether.
If you want specific data or want to read more I recommend starting with these two papers:
I am a GP working in Broome, NW of Western Australia. I work as a hospital DMO (District Med Officer) doing Emergency, Anaesthestics, some Obstetrics and a lot of miscellaneous primary care. Also on the web as @broomedocs | + Casey Parker | Contact