• linkedin
  • Increase Font
  • Sharebar

    New vancomycin dosing tool

    As a pharmacy student, I always wondered why vancomycin dosing wasn't already computerized. Since it is a repetitive process involving reuse of the same equations, it struck me that it would be more efficient to delegate most of the processes to a program, as long as we know how to use it.

    Dosing antibiotics has become a significant element of the pharmacist’s role in hospital settings. In my observations, dosing vancomycin (and aminoglycosides) is quite common and time-consuming for many pharmacists, and everyone has their own methods. While many hospitals define protocols for vancomycin dosing, a decent amount of flexibility is given to the pharmacist. With the pharmacy community so closely knit, it is time we find a way to unify this method and maximize efficiency.

    The existing mobile apps for dosing vancomycin do not impress me; it is difficult to see where the numbers are coming from, as well as to control certain parameters (for example, how you choose to calculate creatinine clearance).

    Within development of such a tool, we still want to leave enough flexibility for the pharmacist's decision-making. As a student, I had put my vancomycin dosing equations into a spreadsheet. I realized later, on rotations, that this would be useful to practicing pharmacists and would make an excellent mobile app. The aim of this article is to outline this method of dosing vancomycin and to introduce you to this tool. I hope this is helpful!

    Vancomycin Dosing Tool

    Click on the image above to download the chart.

    This app is currently available on Android smartphones and coming soon to iPhone and tablets.

    References

    1. Hull JH, Sarubbi FA. Gentamicin serum concentrations: Pharmacokinetic predictions. Ann Intern Med. 1976;85(2):183–9.

    2. Sarubbi FA, Hull JH. Amikacin serum concentrations: Prediction of levels and dosage guidelines. Ann Intern Med. 1978;89(5 Pt 1):612–8.

    3. UNC Eshelman School of Pharmacy. Clinical Pharmacy Pocket Guide 2011. Triangle College of Clinical Pharmacy – Student Chapter. 

    Deanna Wung is a recent PharmD graduate of UNC Chapel Hill Eshelman School of Pharmacy. Contact her at [email protected] 

     

    3 Comments

    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • DeannaWung
      For those who didn't see the link to the app, here it is: https://play.google.com/store/apps/details?id=air.PharmaSolve We also have got it on the Apple app store now too: https://itunes.apple.com/us/app/pharmacokinetics-aid/id893044839?
    • Anonymous
      About 10 years ago, I too created an Excel program with separate calculators for Prospective, Peak/trough, Trough only, Random levels, prospective with amputatons all for vanc and aminoglycosides as well as one for phenytoin. I am very good at kinetics and found that I had no need for manipulating the equations on a daily basis when doing kinetics. In fact, one of the reasons I created my program was to have a tool that I knew would get the math right, and to give me more time to consider the other clinical factors that might influence how I dose a patient. I didn't create this for my hospital, I created it for myself and then found that more and more of my fellow pharmacists were asking to use it. This turned out to be a blessing in that I had people beta-testing it in real time and I was using their feedback to continually make improvements. I considered going the app route, but I found that what I liked best about Excel was being able to see all the info on one screen. I use a desktop on the floor anyway, but if were to dose on the fly, I would much rather use Excel on an iPad vs. an app. My prospective calculator also has a CrCl Comparators section and a newly added Cmax/Cmin Accumulation Timeline provides additional functionality. If anyone would like to try it out, email me at [email protected] I will email it too you and would be happy to answer any questions you might have regarding its use.
    • Anonymous
      This doesn't look like an app. It looks more like a reference page to keep the formulas handy. Using a spreadsheet for calculations should be simple and user friendly. Years ago I developed one for our hospital pharmacists to use that only required the patient's age, height, weight and serum creatinine to be entered. The spreadsheet would do all the calculations for the dose and the estimated creatinine clearance would determine the dosing interval. I would not find this "app" useful at all.
    Slideshows
    Small Doses: The Weekly News You Need to Know
    Small Doses: The Weekly News You ...

    Small doses is a weekly slideshow of the news you may have missed, made just for you and your busy lifestyle.