What is drug utilization evaluation due?

Drug Utilization Evaluation (DUE): A qualitative evaluation of drug use, prescribing, and member fill patterns to determine the appropriateness of drug therapy.

What is the target of the drug vancomycin?

When it reaches the cell wall of an actively dividing susceptible gram-positive bacterium, vancomycin binds to the acyl-D-ala-D-ala portion of the growing cell wall. After binding, it prevents the cell wall from forming the cross-linking necessary to keep it strong.

What are the indications for vancomycin?

INDICATIONS AND USAGE It is indicated for penicillin-allergic patients, for patients who cannot receive or who have failed to respond to other drugs, including the penicillins or cephalosporins, and for infections caused by vancomycin-susceptible organisms that are resistant to other antimicrobial drugs.

When is vancomycin prescribed?

Vancomycin is used to treat infections caused by bacteria. It works by killing bacteria or preventing their growth. Vancomycin will not work for colds, flu, or other virus infections. Vancomycin injection is also used to treat serious infections for which other medicines may not work.

Why is dur required?

The purpose of DUR is to ensure drugs are used appropriately, safely and effectively to improve patient health status. Predetermined criteria for appropriate drug therapy are compared against a patient’s or a population’s records.

What is the difference between Dur and due?

Here is their generally accepted differentiation of the terms: “In some cases, authors have distinguished the two by stating that DUR uses pharmacy claims data, whereas DUE includes use of patient chart data.”

How often should vancomycin levels be checked?

At minimum, levels should be obtained for all patients by 72 hours of therapy and at least weekly thereafter. Many patients will require more frequent monitoring. Chemistries and CBCs should also be checked at least weekly.

How do you evaluate vancomycin effectiveness?

Vancomycin efficacy in bacterial killing is associated with the area under the plasma concentration-time curve from 0 to 24 hours (AUC0-24) over minimum inhibitory concentration (MIC). 1, 6-10 Clinical efficacy is more likely to be achieved when vancomycin dosing achieves an AUC0–24/MIC ≥ 400.

What should you assess before giving vancomycin?

Assess any back or neck pain to rule out musculoskeletal pathology; that is, try to determine if pain is drug induced rather than caused by anatomic or biomechanical problems. Monitor for signs of eosinophilia (fatigue, weakness, myalgia) or leukopenia (fever, sore throat, signs of infection).

What happens if vancomycin doesnt work?

If patients do not respond, vancomycin can be increased to 2 g daily and the addition of IV metronidazole and/or vancomycin enemas can be considered, as well as early surgical consultation.

What is the most serious side effect of vancomycin?

This medicine may cause serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and linear IgA bullous dermatosis (LABD).

What are the drug utilization management rules?

Utilization management restrictions (or “usage management” or “drug restrictions”) are controls that your Medicare Part D (PDP) or Medicare Advantage plan (MAPD) can place on your prescription drugs and may include: Quantity Limits – limiting the amount of a particular medication that you can receive in a given time.

What are the types of utilization review?

Utilization review contains three types of assessments: prospective, concurrent, and retrospective.

Why is DUR required?

Which bacteria is intrinsically resistant to vancomycin?

casseliflavus–E. flavescens are intrinsically resistant to low levels of vancomycin but remain susceptible to teicoplanin (Table 1).

How do you monitor AUC for vancomycin?

The Rodvold method relates patient-specific creatinine clearance (CrCl) to total body clearance of vancomycin (11) and is calculated as follows: AUC = dose/[(CrCl × 0.79) + 15.7] · 0.06, in which dose is the total daily vancomycin dose (mg) and CrCl (mL/min) is calculated via the Cockcroft–Gault equation.

What do I monitor vancomycin with?

Vancomycin Monitoring

• Vancomycin serum concentrations should be checked to optimize therapy and used as a surrogate marker of effectiveness.
• Trough, rather than peak, levels should be monitored.
• Trough levels should be checked just before the fourth dose, when steady-state levels are likely to have been achieved.

What is the most important consideration for the nurse administering the vancomycin?

Some considerations for nurses administering vancomycin include ensuring a patent IV line, planning for administration of the preoperative dose as much as two hours before the initial incision is made, and including information about the dose and timing of preoperative vancomycin administration in the surgical time out …