Dose Enhancement of Vancomycin IN Everyday Patients
Dose Enhancement of Vancomycin IN Everyday Patients
Current Australian guidelines for vancomycin commonly underdoses individuals particularly in
 the first 48 hours.

 The aim of the trial is to compare two dosing regimens; the current Australian guidelines
 versus a more appropriately modeled pharmacokinetic based regimen with the overall aim of
 developing a new vancomycin dosing strategy that will enable patients to have more
 individualised and therapeutically efficacious treatment.

 The hypothesis is that dosing vancomycin according to a pharmacokinetically modeled regimen
 increases the likelihood of achieving therapeutic trough levels of vancomycin within the
 first 48 hours (or at steady state, whichever is sooner) compared to dosing vancomycin
 according to the current Antibiotic guidelines.
DEVINE will be a randomised controlled trial of a new vancomycin dosing regimen against a
 control.

 The control group regimen will receive the doses recommended by Therapeutic Guidelines -
 Antibiotics 2010. The intervention group will receive a dosing regimen that has been devised
 by modelling the antibiotic properties within the body over a large range of renal function
 and weight that will be more specific for the individual patient. They will receive this
 regimen for approximately 36-60 hours at which point they will have a vancomycin level blood
 test (a routine practice as part of their normal care). After this time the treating team
 will determine further dosing requirements.

 All patients will be randomised at commencement of vancomycin with consent being obtained for
 the trial prior to the first dose of vancomycin
Inclusion Criteria:

 -  All patients in general wards requiring routine treatment with vancomycin

 Exclusion Criteria:

 -  GFR < 30mL/min(as measured by Cockcroft Gault equation)

 -  Age < 16 yrs

 -  Weight > 200kg

 -  Patients dosing with Vancomycin other than BD according to national guidelines (ie
 continuous infusions, q6h etc)

 -  Vancomycin infused at a rate other than 500mL/min