scholarly journals Prospective evaluation of vancomycin therapeutic usage and trough levels monitoring

2018 ◽  
Vol 12 (11) ◽  
pp. 978-984 ◽  
Author(s):  
Wissam K Kabbara ◽  
Ghada El-Khoury ◽  
Nour R Chamas
Keyword(s):  
Trough Level ◽  
Tertiary Care ◽  
Therapeutic Index ◽  
Therapeutic Window ◽  
Patient Specific ◽  
Care Hospital ◽  
Therapeutic Level ◽  
Appropriate Use ◽  
Level Monitoring ◽  
Trough Level Monitoring

Introduction: Vancomycin is the cornerstone of parenteral therapy for serious methicillin resistant Staphylococcus aureus infections. Optimal dosing of vancomycin is patient specific due to its narrow therapeutic window. The objective of this study is to evaluate the appropriate use of vancomycin focusing on the indication, dose, and therapeutic level monitoring. Methodology: A prospective observational study was conducted in a tertiary care hospital over a 3- month period. A data collection form was used to gather information on 93 patients receiving vancomycin. Study outcomes were assessment of the appropriateness of vancomycin indication, dose, and therapeutic trough level. Results: The use of vancomycin both empirically and after culture results was appropriate in 78.5 % of the patients. More than half of the patients (51.6 %) were given an inappropriate dose of vancomycin per actual body weight, creatinine clearance, and  indication. Regarding therapeutic vancomycin monitoring, 69.0 % had inappropriate trough level monitoring. Only 15.7 % of the 166 measured troughs were within the target therapeutic level for the corresponding indication. Conclusion: This study demonstrates the high level of inappropriate use of vancomycin. This is mainly attributed to inappropriate dose and trough level monitoring. Interventions to improve vancomycin prescribing and monitoring practices are needed. The presence of an interdisciplinary team may improve the appropriate use of medications with a narrow therapeutic index such as vancomycin.

Comparison of three immunoassays for infliximab trough level monitoring in paediatric inflammatory bowel diseases

Biologicals ◽  
2021 ◽  
Vol 70 ◽  
pp. 17-21
Author(s):  
Juliette Villemonteix ◽  
Valérie Guérin-El Khourouj ◽  
Jean-Pierre Hugot ◽  
Caroline Giardini ◽  
Guislaine Carcelain ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Trough Level ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Level Monitoring ◽  
Trough Level Monitoring

scholarly journals Are we operating unnecessarily?: caesarean audit in a single unit of a private tertiary care hospital in North India

2020 ◽  
Vol 9 (3) ◽  
pp. 975
Author(s):  
Nidhi Singh ◽  
Manjusha .
Keyword(s):  
Caesarean Section ◽  
Urban Areas ◽  
Single Unit ◽  
Financial Burden ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Appropriate Use ◽  
Maternal Request

Background: Caesarean section emerged as a lifesaving surgery in situations where vaginal delivery could put the mother and fetus at risk. Over the years global rise in caesarean delivery rate has been alarming and may be attributed to changes in medical practice and societal expectations, especially in urban areas and developing countries. Rising caesarean rate is worrisome as it increases maternal morbidity, exposes the mother to future obstetric risks, besides increasing financial burden on the health care system. Caesarean audits could be an effective tool to analyse, understand and propose solutions to reduce caesarean rates. Hence, this retrospective study was conducted to audit caesarean sections done over a period of 5 years (2011 to 2015) in a single unit of a tertiary care private hospital in North India.Methods: The case records of all caesarean deliveries from January 2011 to December 2015 were analysed retrospectively for demographic profile, clinical parameters and recorded indication of caesarean section on the basis of Robson’s classification.Results: The caesarean section rate in the study was 61.8%. According to Robson’s 10 system classification, Group 2, 5 and 10 were the largest contributors. The commonest indication was previous LSCS (18.7%) followed closely by fetal distress (15.4%) and prolonged labor/failed induction (13.3%). Maternal request contributed 10.6% of the Caesarean deliveries.Conclusions: The caesarean section rate in our study is way higher than the national average. We need to re-duce caesareans in primigravidae and consider VBAC where appropriate. Use of Electronic fetal monitoring during labor needs to be optimized. Appropriate use of oxytocics, proper monitoring and using robust criterion to infer non progress of labor are important. Appropriate counselling and assured pain management during labor may help reduce caesareans on maternal request.

Cyclosporine A: peak or trough level monitoring in renal transplant recipients?

2001 ◽  
Vol 33 (7-8) ◽  
pp. 3122-3123 ◽  
Author(s):  
R. Wacke ◽  
B. Drewelow ◽  
G. Kundt ◽  
E.-M. Hehl ◽  
R. Bast ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Cyclosporine A ◽  
Trough Level ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Level Monitoring ◽  
Trough Level Monitoring

scholarly journals Adverse Drug Reactions of Antiepileptic Drugs in the Neurology Department of a Tertiary Care Hospital, Srinagar, Jammu & Kashmir, India

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Mudasir Maqbool ◽  
Dinka Dugassa ◽  
Ginenus Fekadu
Keyword(s):  
Drug Therapy ◽  
Antiepileptic Drugs ◽  
Adverse Drug Reactions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Therapeutic Index ◽  
Outpatient Setting ◽  
Care Hospital ◽  
Drug Reactions ◽  
Study Results

Background: Epilepsy is a disorder that affects 1% of the global population. It is the second most common serious neurologic disorder after stroke, affecting humans. Since antiepileptic drugs have a narrow therapeutic index and their adverse effects can affect any organ, their widespread use has significant safety implications. Objectives: The study assessed adverse drug reactions (ADRs) using antiepileptic drugs in the Department of Neurology at a Tertiary Care Hospital, Srinagar, Jammu & Kashmir, India. Methods: This prospective observational study was conducted in the Department of Neurology of a Tertiary Care Hospital, Srinagar, Jammu & Kashmir, India, for eight months. It was a spontaneous reporting of ADRs by practicing physicians in the outpatient and inpatient settings that were included in the study. Results: Of the 3,300 patients who were on the anti-epileptic drug (AED), 92 (3.07%) had AED-related ADRs. A total of 18 cases were reported in the inpatient department and 74 cases in the outpatient setting. The most common ADRs were loss of appetite (34.78%), skin rashes (17.39%), and gum hypertrophy (9.78%). Of 80 ADRs, 42.5% were related to valproate, followed by phenytoin, carbamazepine, and levetiracetam. The suspected drug was changed in 22 patients with ADRs. Conclusions: For the early diagnosis and avoidance of ADRs, the frequent follow-up of patients on AEDs is needed to improve patient compliance with drug therapy and provide better drug therapy for avoiding associated morbidity and mortality.

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