Hospital Pharmacies Pushing for Use of New Vancomycin Guidelines Despite COVID-19

In March 2020, the new guidelines for vancomycin dosing were released, with the major changes including the transition from a trough-based monitoring process to area under the curve (AUC)-based dosing strategies.¹

A survey conducted between March 30 and April 6 by InsightRx found that implementing the new vancomycin guidelines into the pharmacy community is as important as coronavirus disease 2019 (COVID-19) in the health care system. Further, a second survey was conducted by Sage Growth Partners in April 2020 to assess pharmacists’ sentiments regarding newly released vancomycin dosing guidelines and related precision dosing topics.^1,2

In the April survey, 126 pharmacists were questioned on topics that included their plans to adopt the new vancomycin guidelines and related precision dosing issues. Nearly half of the participants were directors of pharmacy, with 92% working in short-term acute care hospitals.²

Some of the key findings of the survey include 52% of respondents indicating that accurately dosing drugs with a narrow therapeutic window, such as vancomycin, is moderately challenging, whereas 33% said it is very or extremely challenging.²

As for the most prevalent approaches for estimating vancomycin doses, 55% of respondents base their estimates on professional judgement compared with 49% who base theirs on manual calculation methods.²

Although 98% of respondents said that the new vancomycin guidelines are important for patient safety, 86% of respondents are still using trough-based dosing, which the new consensus guidelines recommend be discontinued.²

Despite the appreciation of the benefits of the new vancomycin guidelines, only 31% of respondents plan to adopt the new recommendations, whereas 60% are uncertain whether they will do so. Two of the major reasons for not shifting to AUC-guided dosing include not having the budget for the proper software and being content with current vancomycin dosing methods.²

REFERENCES

• Murphy, Jill. Survey shows adopting new vancomycin guidelines is priority for pharmacists despite pandemic. Pharmacy Times. https://www.pharmacytimes.com/news/survey-shows-adopting-new-vancomycin-guidelines-is-priority-for-pharmacists-despite-pandemic. Published April 16, 2020. Accessed August 7, 2020.
• New vancomycin guidelines: despite pandemic, hospital pharmacists pushing to adopt. InsightRx. https://content.insight-rx.com/vanco-report. Accessed August 7, 2020.