Related Experiment Video
Updated: Jun 12, 2026
06:18
A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
A protocolized approach to vancomycin dosing in conventional hemodialysis
Raphael Panais1, David Jay Hirsch, Christine Dipchand
1Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Journal of Nephrology
|June 12, 2010
Summary
This study evaluated an automated vancomycin dosing protocol for hemodialysis patients. The protocol effectively achieved therapeutic vancomycin levels and eradicated infections in most cases.
Area of Science:
- Pharmacology
- Nephrology
- Infectious Diseases
Background:
- Automated intravenous vancomycin dosing protocol implemented for hemodialysis patients.
- Evaluation of protocol effectiveness in achieving therapeutic drug levels and treating infections.
Purpose of the Study:
- To assess the efficacy of an automated vancomycin dosing protocol in hemodialysis patients.
- To determine if the protocol achieves target vancomycin trough levels (10-20 mg/L).
Main Methods:
- Prospective cohort study of hemodialysis patients from August 2005 to May 2007.
- Vancomycin loading dose based on weight, followed by fixed subsequent doses.
- Dose adjustments based on predialysis trough levels, with therapeutic range of 10-20 mg/L.
Main Results:
- 81 out of 93 vancomycin levels were within the therapeutic range.
- 35 out of 36 infection episodes were successfully eradicated.
- No significant difference in dose adjustment requirements based on membrane type or timing of initial adjustment.
Conclusions:
- The automated vancomycin dosing protocol successfully achieved therapeutic levels and treated infections in hemodialysis patients.
- The protocol was effective regardless of membrane type (high- or low-flux).
- No vancomycin-related side effects were identified during the study period.
Related Concept Videos
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:20Estimation of k and VD of Aminoglycosides
Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:25Hemodialysis III: Nursing Management
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...