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Updates and Future Directions

One-Hour Concurrent Session

Take It to New Levels: Optimizing Antibiotic Dosing Using the Latest Monitoring and Dosing Strategies

Thursday, April 21, 2022

11:00 AM – 12:00 PM US CST

CE: 1.0

Concurrent Session Moderator(s)

Edward Van Matre, BCCCP, MS, PharmD

Assistant Professor
University of Tennessee College of Pharmacy
Memphis, Tennessee

No relevant financial relationship(s) to disclose

Guidelines for vancomycin area under the curve (AUC)/minimum inhibitory concentration (MIC) monitoring were published by the Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society of Infectious Diseases Pharmacists in March 2020. Many institutions are developing new protocols for monitoring vancomycin, including updated recommendation from the guidelines to use AUC/MIC monitoring in place of traditional trough monitoring. In addition, recent literature has promoted the use of continuous-infusion beta-lactam dosing. In this flipped classroom session, attendees will bring local protocols and dosing schemes to launch a comparison with the newly published guidance and compare strategies by using audience polling. Advantages and disadvantages of two-level AUC pharmacokinetics and more advanced Bayesian AUC pharmacokinetics will be reviewed in an interactive session using simulated patient data, including initial dosing schemes and dosage revisions. A similar approach will be taken to determine time > MIC dosing for beta-lactam antibiotics using therapeutic drug monitoring techniques and extended/continuous-infusion dosing approaches.

Learning Objectives:

Describe physiologic changes that affect pharmacokinetics and pharmacodynamics of antibiotic administration in critically ill patients and how these impact monitoring and dosing strategies
Discuss successful implementation techniques for monitoring vancomycin in critically ill patients based on the vancomycin monitoring guidelines
Evaluate strategies for optimizing beta-lactam dosing using continuous or extended infusions in critically ill patients

Presentations:

How to Get the Best Curves: Dosing Vancomycin Using Area Under the Curve Monitoring
Concurrent Session Faculty: Siu Yan Amy Yeung, BCCCP, BCPS, PharmD – University of Maryland Medical Center
How Slow Can You Go? Alternate Dosing Strategies for Beta-Lactam Antibiotics
Concurrent Session Faculty: Melissa Thompson Bastin, BCCCP, PharmD, PhD – University of Kentucky HealthCare