Model-informed Precision Dosing of Vancomycin in Adults

Vancomycin is an antibiotic with a narrow therapeutic-toxic margin. This means that the minimum and maximum target blood target levels differ little from each other. Too low concentrations will reduce the effect of the antibiotic; higher concentrations may result in serious side effects, including renal toxicity. Vancomycin dosing tailored to the individual patient is challenging.

Currently, the vancomycin dose is adjusted based on a measured vancomycin blood concentration (if too high or too low). Despite this measurement, quickly achieving target concentrations remains a major challenge.

This multicenter, individual randomized study investigates the added value of a user-friendly computer program for calculating the vancomycin dose in non-critically ill adults, compared to the current standard-of-care. Specifically, the investigators will study whether the use of this computer program leads to a shorter time to reach target concentrations, a reduction in the number and severity of side effects on the kidney and a reduction in patient burden.

Inclusion criteria

• 18 years or older
• admitted to a participating ward unit
• a suspected or confirmed Gram positive infection
• planned to start of started on intravenous continuous infusion vancomycin treatment
• participant or legal representative signed the informed consent form
• not previously enrolled in this trial

Exclusion criteria

• serum creatinine level at inclusion is above 2.5 mg/dL
• undergoing extracorporeal treatment at inclusion (e.g. extracorporeal membrane oxygenation, dialysis, body cooling)
• patient death is deemed imminent and inevitable.