Nearly All ICU Vancomycin Patients Qualify for Missing TDM
A retrospective ICU audit quantifies how many critically ill vancomycin recipients meet guideline-based therapeutic drug monitoring criteria in a setting where monitoring was unavailable.
vancomycintherapeutic drug monitoringMRSAintensive carepharmacokineticsantimicrobial stewardshipnephrotoxicityretrospective studyPharmacokinetics / TDM
Background Information
Nearly all ICU patients on vancomycin need TDM monitoring.
Vancomycin is vital for treating severe methicillin-resistant Staphylococcus aureus (MRSA) infections in ICUs, but monitoring its therapeutic levels is challenging without therapeutic drug monitoring (TDM). In a Turkish ICU, 96.4% of vancomycin-treated patients met the criteria for TDM, with common indications including prolonged therapy and altered pharmacokinetics. The lack of TDM poses challenges in ensuring effective vancomycin use, highlighting the need for improved monitoring infrastructure especially in similar resource-limited settings. Nearly all ICU patients on vancomycin need TDM, underscoring the importance of monitoring in critical care.
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Authors:Ayhan YE, Sarı Küçük R, Özkan AN, Akay Gedi̇k H, Şi̇mşek F, Bektay MY
Citation:Ayhan YE, Sarı Küçük R, Özkan AN, et al. Guideline-informed vancomycin therapeutic drug monitoring indications in an adult intensive care unit: a retrospective descriptive study. BMC anesthesiology. 2026. doi:10.1186/s12871-026-04078-2
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Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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