Evaluation of therapeutic vancomycin monitoring in patients with and without hemodialysis in a medium-sized hospital in Southern Brazil

Authors

DOI:

https://doi.org/10.17058/reci.v16i.20618

Keywords:

Renal dialysis, Therapeutic index, Drug, Vancomycin

Abstract

Background and Objectives: Vancomycin is a glycopeptide antibiotic widely used in hospital settings for the treatment of severe infections caused by resistant Gram-positive bacteria, particularly methicillin-resistant Staphylococcus aureus(MRSA). Due to its narrow therapeutic window and high interindividual pharmacokinetic variability, therapeutic drug monitoring (TDM) is essential to ensure effective and safe therapy. The purpose of this study was to evaluate local practices for TDM of vancomycin in a medium-sized hospital in southern Brazil by comparing patients with and without hemodialysis, identifying failures in achieving therapeutic levels. Methods: This retrospective study was conducted between September 2023 and September 2024 in a medium-sized hospital in Southern Brazil. Local TDM practices for vancomycin were evaluated, focusing on patients with and without the need for intermittent hemodialysis. Results:Thirty-three adult inpatients were included and categorized into four groups based on dialysis status and whether vancomycin levels were monitored. Among the 19 patients who underwent TDM, only six achieved therapeutic concentrations (15–20 mg/L). Notably, all patients in the hemodialysis monitoring group (HDV) presented supratherapeutic levels at first measurement (mean: 33.7 mg/L). In the non-dialysis monitored group (NDV), high variability in initial serum concentrations was observed (mean: 26.3 mg/L; CV: 40%). Conclusion: These findings support the urgent implementation of structured TDM workflows led by clinical pharmacists, integrated into electronic medical records, and supported by pharmacokinetic modeling and clinical decision tools. Institutional adoption of AUC/MIC-based monitoring, pharmacist-led interventions, and multidisciplinary education are critical to ensure the rational and safe use of vancomycin.

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Author Biographies

  • Guilherme, Mestrado Profissional em Farmacologia, Departamento de Farmacologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brasil

    Farmacêutico, graduado pela Universidade Federal de Santa Catarina (UFSC). Durante a graduação me dediquei em agregar experiências em distintas áreas de atuação do farmacêutico, exercendo as atividades de estagiário no Hospital Universitário no setor de Bioquímica do Laboratório de Analises Clinicas e na Unidade de Analises Físico Química de Medicamentos (FQMED) do Laboratório Central de Analises (LACEN). Participei de monitorias voluntárias a fim de obter um maior compreendimento da disciplina e aperfeiçoamento do conhecimento obtido já no semestre que foi cursado, além de Projeto de Pesquisa com Óleos essenciais e plantas medicinais relacionado a variação sazonal e atividade biológica do óleo essencial.

  • Helena, Mestrado Profissional em Farmacologia, Departamento de Farmacologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brasil

    Graduada em Farmácia e Bioquímica pela Universidade Católica de Pelotas (1998), Mestre (2001) e Doutora (2005) em Ciências Biológicas (Bioquímica) pela Universidade Federal do Rio Grande do Sul (doutorado-sanduíche no Florey Institute of Neuroscience and Mental Health, Universidade de Melbourne, Austrália, 2003 - 2004). Pós-doutorado na Universidade de Bristol, Reino Unido (2006 - 2009), como bolsista Marie Curie e subsequentemente pesquisadora associada. De 2010 a 2014 atuou como Lecturer in Pharmacology da Universidade de Reading, Reino Unido. Sabático de pesquisa na Universidade de Kyoto, Japão (Jun-Set 2012). Desde 2015 é Professora Adjunta do Departamento de Farmacologia da Universidade Federal de Santa Catarina e Bolsista de Produtividade em Pesquisa do CNPq. Orientadora pelos Programas de Pós-graduação em Farmacologia (Acadêmico e Profissional) e Neurociências. Extensa experiência nas áreas de Farmacologia bioquímica e molecular e Neurociências. As principais linhas de pesquisa envolvem doenças neurodegenerativas, como Alzheimer e Parkinson, neuroproteção, plasticidade sináptica, sinalização celular e modificação pós-traducional de proteínas.

  • José, Hospital e Maternidade OASE, Timbó, Santa Catarina, Brasil

    Possui graduação em Farmácia pela Pontifícia Universidade Católica de Campinas(1987), graduação em Medicina pela Pontifícia Universidade Católica de Campinas(1994) e residencia-medicapela Pontifícia Universidade Católica de Campinas(1998). Atualmente é Infectologista da Prefeitura Municipal de Pomerode, Infectologista da Hospital Maternidade Oase Timbó, Infectologista da Unimed Blumenau, Infectologista da Prefeitura Municipal de Indaial e Consultor Infectologia da Hospital Dr. waldomiro Colautti. Tem experiência na área de Medicina.

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Published

2026-06-14

Issue

Vol. 16 (2026)

Section

ORIGINAL ARTICLE

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Copyright (c) 2026 Guilherme Raimundo, Helena Cimahosti, José Elias Amaral

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How to Cite

Raimundo, G., Cimahosti, H., & Elias, J. A. . (2026). Evaluation of therapeutic vancomycin monitoring in patients with and without hemodialysis in a medium-sized hospital in Southern Brazil. Revista De Epidemiologia E Controle De Infecção, 16. https://doi.org/10.17058/reci.v16i.20618