RT Book, Section
A1 Rybak, Michael J.
A1 Aeschlimann, Jeffrey R.
A1 LaPlante, Kerry L.
A2 DiPiro, Joseph T.
A2 Talbert, Robert L.
A2 Yee, Gary C.
A2 Matzke, Gary R.
A2 Wells, Barbara G.
A2 Posey, L. Michael
SR Print(0)
ID 1145264766
T1 Laboratory Tests to Direct Antimicrobial Pharmacotherapy
T2 Pharmacotherapy: A Pathophysiologic Approach, 10e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259587481
LK accesspharmacy.mhmedical.com/content.aspx?aid=1145264766
RD 2024/04/19
AB Content  UpdateJuly  12,  2017Using  Cystatin  C  to  Guide  Vancomycin  Dosing:  Cystatin  C  is  a  renal  biomarker  that  has  been  proposed  to  be  used  as  an  alternative  to  or  in  conjunction  with  creatinine  for  estimating  glomerular  filtration  rate  (GFR).  Two  recent  studies  employed  a  practical  approach  to  development  and  implementation  of  a  cystatin  C-inclusive  vancomycin  dosing  nomogram  in  clinical  practice.  The  authors  developed  a  dosing  nomogram  that  used  CKD-EPIcreatinine-cystatinC  based  estimated  GFR  (eGFRcr-cysC)  as  well  as  the  target  vancomycin  trough  level  and  patient  weight.  The  authors  then  conducted  a  QI  project  to  evaluate  the  routine  use  of  this  nomogram  in  critically-ill  patients.  Use  of  the  CKD-EPIcreatinine-cystatinC  equation  to  estimate  GFR  for  vancomycin  dosing  was  shown  to  be  feasible  and  was  associated  with  a  clinically  and  statistically  significant  increase  in  target  vancomycin  trough  achievement.  Additional  prospective  research  is  warranted.