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Showing posts from May, 2018

"Getting Serious About Vancomycin Selection and Dosing" by Steven P. LaRosa, M.D.

Introduction As an Infectious Disease physician and Antimicrobial Stewardship Director I encounter a large number of patients who have been empirically started on Vancomycin due to a concern for MRSA infections or Gram positive infection with a reported penicillin allergy. I often see patients being given 1gm IV q 12hours without any attention to seriousness of illness, body weight, kidney function or susceptibility of the infecting organism. This blog will address how to optimize the use and dosing of Vancomycin. Is Vancomycin even necessary? Vancomycin is quite often given as part of empiric therapy for pneumonia and skin and soft tissue infections without much thought as to if it is necessary. A good starting point in the evaluation of the need for Vancomycin is to a "chart biopsy" on the patient. In the evaluation of the EMR I look for past cultures or MRSA screen results. This exercise may reveal that the patient has had in fact MSSA and not MRSA colonization/