The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study
Background: The emergency department (ED) is a crowded area with complex workflow. Broad spectrum antibiotics given within the first hour of recognizing sepsis have proven to lower the mortality rate. Initiating optimal dose of Vancomycin to attain targeted serum level is an important role of emerge...
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| Format: | Article |
| Language: | English |
| Published: |
Discover STM Publishing Ltd
2021-12-01
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| Series: | Saudi Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ejmanager.com/fulltextpdf.php?mno=33499 |
| _version_ | 1797788645772492800 |
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| author | Waad H. Al-Kathiri Abdullah S. Alharthi Fatimah H. Albeladi Hejab A. AlDawsari Adnan A. Alweqayyan Mohammed S. Alshahrani Fahad T. AlBarakati Abdulaziz M. Alghonaim Mohammad A. Aldowsari Abdullah N. Attar Ghaida R. A. Alzahrani Azzam A. Shaikh Abdulaziz S. Aldakhil Efham H. Alsueaadi Ahmad H. Alkathiry Najla Tariq Alhowail |
| author_facet | Waad H. Al-Kathiri Abdullah S. Alharthi Fatimah H. Albeladi Hejab A. AlDawsari Adnan A. Alweqayyan Mohammed S. Alshahrani Fahad T. AlBarakati Abdulaziz M. Alghonaim Mohammad A. Aldowsari Abdullah N. Attar Ghaida R. A. Alzahrani Azzam A. Shaikh Abdulaziz S. Aldakhil Efham H. Alsueaadi Ahmad H. Alkathiry Najla Tariq Alhowail |
| author_sort | Waad H. Al-Kathiri |
| collection | DOAJ |
| description | Background: The emergency department (ED) is a crowded area with complex workflow. Broad spectrum antibiotics given within the first hour of recognizing sepsis have proven to lower the mortality rate. Initiating optimal dose of Vancomycin to attain targeted serum level is an important role of emergency physicians and pharmacists.
Objective: To evaluate the efficacy and safety of Vancomycin loading dose (VLD) (25-35 mg/kg) in reaching the targeted Vancomycin serum trough level compared to regular dose (15-20 mg/kg) in ED. Study design and settings: A multicenter, retrospective, cohort study.
Methods: The study was carried out in four hospitals in Saudi Arabia; patients who received VLD were matched in a 1:1 fashion based on age category and diagnosis suspected in the ED. Inclusion criteria were age ≥14 years, diagnosed with serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA), and microbiology culture confirmed MRSA. Exclusion criteria were missing weight, SCr, or Vancomycin trough level, patient on dialysis therapy/continuous renal replacement therapies, and concomitant use of nephrotoxic drugs at ED.
Results: Over the 1-year study period, a total of 3,746 patients were prescribed Vancomycin in the ED. 232 patients received VLD matched to 232 patients received regular dose. Mean dose were 25.3 mg/kg (±4.3) and 13.7 mg/ kg (±2.6) for VLD and regular dose groups, respectively. The targeted Vancomycin trough level was significantly reached with the VLD group within 24 hours post-initial dose vs regular dose [18.7 (±3.2) vs. 11.6 (±4.3), respectively, p < 0.0001]. No difference in SCr value was noted post-Vancomycin initial dose between VLD and regular dose groups [1.5 (± 1.5) vs. 1.4 (± 1.8), respectively, p = 0.735]. Nephrotoxicity incident was higher with VDL (33, 14.2%) compared to regular dose, but the difference was not significant (22, 9.5%, p = 0.117).
Conclusion: VLD has a rapid effect in reaching the targeted Vancomycin serum trough level compared to regular dose with a low rate of nephrotoxicity effect. The finding supports the use of VLD in patients admitted to ED who were suspected to have serious infections caused by MRSA. [SJEMed 2021; 2(2.000): 180-185] |
| first_indexed | 2024-03-13T01:39:28Z |
| format | Article |
| id | doaj.art-14bf6e64f23e43048b2e1010df189cb8 |
| institution | Directory Open Access Journal |
| issn | 1658-8487 |
| language | English |
| last_indexed | 2024-03-13T01:39:28Z |
| publishDate | 2021-12-01 |
| publisher | Discover STM Publishing Ltd |
| record_format | Article |
| series | Saudi Journal of Emergency Medicine |
| spelling | doaj.art-14bf6e64f23e43048b2e1010df189cb82023-07-03T16:11:41ZengDiscover STM Publishing LtdSaudi Journal of Emergency Medicine1658-84872021-12-012218018510.24911/SJEMed/72-160856650633499The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort studyWaad H. Al-Kathiri0Abdullah S. Alharthi1Fatimah H. Albeladi2Hejab A. AlDawsari3Adnan A. Alweqayyan4Mohammed S. Alshahrani5Fahad T. AlBarakati6Abdulaziz M. Alghonaim7Mohammad A. Aldowsari8Abdullah N. Attar9Ghaida R. A. Alzahrani10Azzam A. Shaikh11Abdulaziz S. Aldakhil12Efham H. Alsueaadi13Ahmad H. Alkathiry14Najla Tariq Alhowail15King Saud university Medical city, King Saud University, Riyadh, Saudi Arabia Prince Mansour Military Hospital, Armed Forces Hospitals, Taif, Saudi Arabia University of Strathclyde, UK Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia Technical support department, Central Department of primary health care, MOH, Kuwait King Khaled University, Besha, Saudi Arabia King Abdulaziz Hospital, Jeddah, Saudi Arabia Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia Armed Forces Hospital, King Abdulaziz Naval base, Jubail, Saudi Arabia. King Abdulaziz Hospital, Jeddah, Saudi Arabia College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia Specialized Medical Center, Riyadh, Saudi Arabia Security Forces Specialized Comperhensive Clinics, Wadi aldwassir, Saudi Arabia College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia College of Pharmacy,Prince Nourah University, Riyadh, Saudi ArabiaBackground: The emergency department (ED) is a crowded area with complex workflow. Broad spectrum antibiotics given within the first hour of recognizing sepsis have proven to lower the mortality rate. Initiating optimal dose of Vancomycin to attain targeted serum level is an important role of emergency physicians and pharmacists. Objective: To evaluate the efficacy and safety of Vancomycin loading dose (VLD) (25-35 mg/kg) in reaching the targeted Vancomycin serum trough level compared to regular dose (15-20 mg/kg) in ED. Study design and settings: A multicenter, retrospective, cohort study. Methods: The study was carried out in four hospitals in Saudi Arabia; patients who received VLD were matched in a 1:1 fashion based on age category and diagnosis suspected in the ED. Inclusion criteria were age ≥14 years, diagnosed with serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA), and microbiology culture confirmed MRSA. Exclusion criteria were missing weight, SCr, or Vancomycin trough level, patient on dialysis therapy/continuous renal replacement therapies, and concomitant use of nephrotoxic drugs at ED. Results: Over the 1-year study period, a total of 3,746 patients were prescribed Vancomycin in the ED. 232 patients received VLD matched to 232 patients received regular dose. Mean dose were 25.3 mg/kg (±4.3) and 13.7 mg/ kg (±2.6) for VLD and regular dose groups, respectively. The targeted Vancomycin trough level was significantly reached with the VLD group within 24 hours post-initial dose vs regular dose [18.7 (±3.2) vs. 11.6 (±4.3), respectively, p < 0.0001]. No difference in SCr value was noted post-Vancomycin initial dose between VLD and regular dose groups [1.5 (± 1.5) vs. 1.4 (± 1.8), respectively, p = 0.735]. Nephrotoxicity incident was higher with VDL (33, 14.2%) compared to regular dose, but the difference was not significant (22, 9.5%, p = 0.117). Conclusion: VLD has a rapid effect in reaching the targeted Vancomycin serum trough level compared to regular dose with a low rate of nephrotoxicity effect. The finding supports the use of VLD in patients admitted to ED who were suspected to have serious infections caused by MRSA. [SJEMed 2021; 2(2.000): 180-185]http://www.ejmanager.com/fulltextpdf.php?mno=33499vancomycinloading doseemergency departmentnephrotoxicity mrsa |
| spellingShingle | Waad H. Al-Kathiri Abdullah S. Alharthi Fatimah H. Albeladi Hejab A. AlDawsari Adnan A. Alweqayyan Mohammed S. Alshahrani Fahad T. AlBarakati Abdulaziz M. Alghonaim Mohammad A. Aldowsari Abdullah N. Attar Ghaida R. A. Alzahrani Azzam A. Shaikh Abdulaziz S. Aldakhil Efham H. Alsueaadi Ahmad H. Alkathiry Najla Tariq Alhowail The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study Saudi Journal of Emergency Medicine vancomycin loading dose emergency department nephrotoxicity mrsa |
| title | The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study |
| title_full | The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study |
| title_fullStr | The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study |
| title_full_unstemmed | The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study |
| title_short | The impact of Vancomycin loading dose on the emergency department in Saudi Arabia: a multicenter cohort study |
| title_sort | impact of vancomycin loading dose on the emergency department in saudi arabia a multicenter cohort study |
| topic | vancomycin loading dose emergency department nephrotoxicity mrsa |
| url | http://www.ejmanager.com/fulltextpdf.php?mno=33499 |
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