{"id":6687,"date":"2015-01-01T00:00:00","date_gmt":"2015-01-01T05:00:00","guid":{"rendered":"http:\/\/news.christianacare.org\/2015\/01\/a-randomized-trial-of-loading-vancomycin-in-the-emergency-department\/"},"modified":"2015-01-01T00:00:00","modified_gmt":"2015-01-01T05:00:00","slug":"a-randomized-trial-of-loading-vancomycin-in-the-emergency-department","status":"publish","type":"post","link":"https:\/\/research.christianacare.org\/publications\/2015\/01\/01\/a-randomized-trial-of-loading-vancomycin-in-the-emergency-department\/","title":{"rendered":"A randomized trial of loading vancomycin in the emergency department"},"content":{"rendered":"<p>Rosini JM, Laughner J, Levine BJ, Papas MA, Reinhardt JF, Jasani NB<\/p>\n<p>Ann Pharmacother 2015 Jan;49(1):6-13<\/p>\n<p>PMID: <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25358330\" target=\"_blank\">25358330<\/a><\/p>\n<h2>Abstract<\/h2>\n<p><p><strong>BACKGROUND: <\/strong>Optimizing vancomycin dosing may help eradicate bacteria while avoiding resistance. The guidelines recommend loading doses; however, there are no data to demonstrate that this may result in a more rapid achievement of therapeutic troughs.<\/p>\n<p><strong>OBJECTIVE: <\/strong>To evaluate the percentage of troughs reaching therapeutic levels at 12, 24, and 36 hours following an initial vancomycin dose of 30 mg\/kg compared with 15 mg\/kg.<\/p>\n<p><strong>METHODS: <\/strong>This prospective, randomized study was performed in a community academic medical center. Patients who were to receive vancomycin in the emergency department were randomized to an initial traditional dose of 15 mg\/kg or a 30-mg\/kg loading dose followed by 15 mg\/kg every 12 hours for 3 doses. Patients weighing &gt;120 kg or with creatinine clearances &lt;50 mL\/min were excluded.<\/p>\n<p><strong>RESULTS: <\/strong>In total, 99 patients were enrolled; 12 hours after the initial dose of vancomycin, there was a significantly greater proportion of patients reaching target trough levels of 15 mg\/L among the patients who received a loading dose as compared with a traditional dose (34% vs 3%, P &lt; 0.01). This trend continued at 24 hours but was not statistically significant. At 36 hours, there was no difference in the percentage of patients reaching target levels between the 2 groups. No statistically significant difference in nephrotoxicity or adverse events among the 2 groups was demonstrated.<\/p>\n<p><strong>CONCLUSION: <\/strong>A loading dose of 30 mg\/kg of vancomycin achieved a higher percentage of therapeutic levels at 12 hours when compared with the traditional dose of 15 mg\/kg, without increased nephrotoxicity or adverse events.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rosini JM, Laughner J, Levine BJ, Papas MA, Reinhardt JF, Jasani NB Ann Pharmacother 2015 Jan;49(1):6-13 PMID: 25358330 Abstract BACKGROUND: Optimizing vancomycin dosing may help eradicate bacteria while avoiding resistance. The guidelines recommend loading doses; however, there are no data to demonstrate that this may result in a more rapid achievement of therapeutic troughs. OBJECTIVE:<\/p>\n<p><a class=\"more-link\" href=\"https:\/\/research.christianacare.org\/publications\/2015\/01\/01\/a-randomized-trial-of-loading-vancomycin-in-the-emergency-department\/\">Continue reading <span class=\"screen-reader-text\">A randomized trial of loading vancomycin in the emergency department<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6687","post","type-post","status-publish","format-standard","hentry","category-pubs-pres"],"acf":[],"_links":{"self":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts\/6687","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/comments?post=6687"}],"version-history":[{"count":0,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts\/6687\/revisions"}],"wp:attachment":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/media?parent=6687"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/categories?post=6687"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/tags?post=6687"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}