Survey of vancomycin monitoring guidelines in Illinois hospitals

Disparity exists in published recommendations for monitoring of vancomycin serum concentrations. To evaluate the degree of disparity of practice in Illinois, directors of pathology of 202 Illinois hospitals were surveyed to assess their vancomycin monitoring practices. Of the 202 surveys mailed, 82 were returned for a response rate of 41 percent. Most hospitals have 200-500 beds (60 percent) and are nonteaching institutions (72 percent). Two thirds of the hospitals sent vancomycin to an outside laboratory for analysis. Timing of postinfusion (peak) concentrations ranged from 0 minutes following end of infusion to 360 minutes. Approximately one half of the institutions reported a peak therapeutic range of 30-40 mg/L at 30 minutes following end of infusion. A great majority of institutions were consistent in recommended trough range, with 48 of 55 reporting 5-10 mg/L. Although there is some consistency among at least half of the hospitals, there is a great deal of variability among the other half in peak monitoring guidelines.