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PODCAST: Vancomycin by Continuous Infusion

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.

My VANCOMYCIN CONTINUOUS INFUSION PROTOCOL is here for more detail and critique.

So, without further ado, here is the podcast:

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:

Continuous versus intermittent infusion of vancomycin in adult patients: A systematic review and meta-analysis.   Jing-Jing Haoa, Han Chena,b, Jian-Xin Zhoua   International Journal of Antimicrobial Agents,  2015

The dosing and monitoring of vancomycin – what is the best way forward?    Philip G. Drennan , Evan J. Begg , Sharon J. Gardiner , Carl M.J. Kirkpatrick , Steve T. Chambers   International Journal of Microbiological Agents, Dec 2018

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