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OpenTrials
Completed

NCT Number: NCT01162733

Loading Vancomycin Doses in the Emergency Department

In 2008, our ED administered an average of 245 doses of vancomycin per month. Currently there is no consistency in the ED practice in regards to vancomycin dosing. In 2009, the IDSA put forth new recommendations for vancomycin dosing in order to achieve therapeutic levels more rapidly. It has been hypothesized that if therapeutic levels are reached more rapidly then patients will in turn have better clinical outcomes and that the development of resistant organisms will be decreased. Methicillin resistant Staphylococcus aureus (MRSA) has emerged as one of the most deadly pathogens that are currently plaguing our patient population. Vancomycin is one of only a few antibiotics that are effective for treating MRSA. It is imperative that the ED physicians consistently and correctly dose vancomycin in order to give the patients the best chance to fight infection while helping to prevent further resistance in this already highly resistant organism. It is believed this study will reveal that the new dosing recommendations by the IDSA will lead to the achievement of therapeutic levels more rapidly. This information will in turn help to convince ED physicians that a change in current clinical practice is warranted and ultimately lead to better clinically outcomes for the patients.

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Key information

Conditions

Infectious Disease Communicable Diseases Disease Attributes Infections Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Chrisitana Care Health System-Christiana Hospital

Newark, Delaware, 19718, United States

About this study

Recently, the Infectious Disease Society of America (IDSA) has released new dosing recommendations for intravenous (IV) vancomycin. These new recommendations suggest administering an initial dose of 25-30 mg/kg of vancomycin as opposed to 10-15 mg/kg which is more traditionally done. Currently in the Emergency Department (ED) some practitioners are using the new IDSA dosing recommendations for vancomycin, while other practitioners have not changed their clinical practice. There is currently little data available to suggest that implementing these new vancomycin dosing regimens in the ED will achieve therapeutic vancomycin levels more rapidly than our traditional dosing practice.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • At least 18 years of age
  • Treated in Christiana Emergency Department
  • Receiving Vancomycin for an infection or presumed infection
  • Being admitted to Christiana Hospital
  • Planned continued use of Vancomycin after admission.

Exclusion criteria

  • Less than 18 years of age
  • Weight greater than 120 kg.
  • Concurrent use of aminoglycosides or acyclovir
  • Sepsis patients being admitted to ICU with presumed diagnosis of pneumonia
  • Patients currently undergoing dialysis
  • Pregnant or breast feeding
  • No plan to continue Vancomycin after admission.
  • Creatinine clearance less than 50ml/min.

Treatment and study plan

Vancomycin

Drug

15mg/kg

Primary outcomes

  1. Percentage of Participants First Achieving Therapeutic Levels at 36 Hours

    Time frame: 36 hours

    The objective is to determine if therapeutic levels were reached more rapidly with the implementation of an initial vancomycin loading dose of 30 mg/kg as compared to 15mg/kg.

  2. Percentage of Participants First Achieving Therapeutic Levels at 12 Hours

    Time frame: 12 hours

    Percentage of patients reaching a therapeutic level defined as greater than 15 mcg/mL

Sponsors and collaborators

Lead sponsor

Christiana Care Health Services

Other

Registry information

Official study title

A Randomized Prospective Study of Vancomycin Dosing in the Emergency Department: Will a Loading Dose of 30mg/kg Lead to a More Rapid Attainment of Therapeutic Levels?

Acronym: Loaded

Important dates

Study start
2010
Primary completion
2012
Study completion
2012
First posted
Jul 15, 2010
Registry last updated
Mar 13, 2014

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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