Question

Although trough-only monitoring is practical, the potential limitations surrounding the practice suggest that trough monitoring may be insufficient to guide vancomycin dosing in all patients. AUC/MIC ratio is considered the PK/PD driver of efficacy for vancomycin. However, such approach may not be recommended for all patients. Mention three cases where such approach is not needed.

Answer 1

Trough monitoring of vancomycin is nothing but concentration of the vancomycin in the blood which is at the very low level after the period of administration.

Certain cases the trough monitoring approach is nit needed

• If the medication is administered orally it is not needed to assess the trough value as the absorption of the drug dies not take place in the circulatory system
• If the drug is administered rectally in order to treat infection related to gastrointestinal system
• In case of short term therapy which is less thsn three days
• In case of stable patient who had no medical conditions associated with renal or cardiovascular system.