Comparative Evaluation of Pharmacist-Managed Vancomycin Dosing in a Community Hospital Following Implementation of a System-Wide Vancomycin Dosing Guideline

Purpose: Evaluate the implementation of a large hospital system vancomycin dosing guideline in a community hospital with pharmacist vancomycin management. Design: Single center, retrospective and prospective quality assessment study. Methods: Pharmacist-managed vancomycin therapy was evaluated pre and post-implementation of a new dosing guideline in a study population of 586 from one community hospital. Results: Of the study population, 274 patients evaluated pre-implementation were compared to 312 patients post-implementation of the large hospital-system guideline (46.8% and 53.2%, respectively). There was no significant difference in demographics between both patient populations. Days of vancomycin therapy was shorter in the post-implementation group (4.32 ± 2.241) versus the pre-implementation group [(4.81 ± 2.764), p = 0.018]. Days to goal trough was longer in the post-implementation group (3.51 ± 1.622) compared to the pre-implementation group [(3.09 ± 2.046), p = 0.054]. A post-hoc regression analysis was conducted, showing that age, days of vancomycin therapy and goal trough are predictors for 77% of cases within the post-implementation group. Conclusion: The implementation of a new vancomycin dosing guideline significantly impacted days of vancomycin therapy and days to goal trough in patients on vancomycin managed by pharmacists. Our results encourage completion of future studies utilizing the regression analysis data, which may impact the future care of patient on vancomycin managed by pharmacists.