Therapeutic Drug Monitoring of Vancomycin: A State of The Art Review(Pages 8-20)

Siomara Regina Hahn1,2, Joaquim Faria Monteiro3,4, Jorge Gonçalves2 and Paula Fresco2

1Instituto de Ciências Biológicas, Curso de Farmácia, Universidade de Passo Fundo (UPF), Passo Fundo, Brasil; 2Laboratório de Farmacologia, Departamento de Ciências do Medicamento, Faculdade de Farmácia da Universidade do Porto (FFUP), Porto, Portugal; 3Instituto de Investigação e Formação Avançadas em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde (IUCS), Gandra, Portugal; 4Faculdade de Medicina da Universidade do Porto (FMUP, Porto, Portugal)


Abstract: Therapeutic drug monitoring is acknowledged as an important part of the vancomycin therapy management, a fundamental antibiotic in the management of severe Gram-positive infections. Therapeutic failure, bacterial resistance and toxicity is associated with inappropriate vancomycin dosing. The aims of the present work are to present an overview of the current knowledge on therapeutic drug monitoring of vancomycin and how therapeutic drug monitoring should be carried out to improve safety and effectiveness of vancomycin. Based on three international guidelines (American, Japanese and Chinese) and a systematic review (focusing on therapeutic drug monitoring and pharmacokinetic population models), an analysis of the evidence was carried out and allowed us to define the current knowledge on this topic and may re-direct research efforts to respond to the detected knowledge gaps. The therapeutic drug monitoring methodology presents, today, a high level of evidence and practical recommendations with great robustness, representing a practice with clinical and economic relevance.

Keywords: Vancomycin, Pharmacokinetics, Therapeutic Drug Monitoring.