1328. Vancomycin exposure and utilization following implementation of an AUC-guided monitoring guideline in children

摘要

The 2009 guideline for vancomycin (VAN) monitoring recommended trough (TR) of 15-20 mg/L to correlate with AUC/MIC ≥ 400. Studies have suggested attainment of target AUC/MIC ratio with TR 7-11 mg/L in most children. Prior to 2018, TR 15-20 mg/L was the primary target for VAN therapeutic monitoring at CHOC Children’s. Beginning in 2018, a clinical guideline was implemented which recommend targeting AUC/MIC of 400-600 or TR of 7-15 mg/L. Our objectives are to evaluate differences in VAN utilization, exposure, nephrotoxicity and cost savings between pre (Pre-guideline, pG) and post implementation (Post-guideline, PG) of a VAN monitoring guideline at CHOC Children’s.