Cedars-Sinai Medical Center

medical staff pulse newsletter

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF June 30, 2017 | Archived Issues

Meetings and Events


Grand Rounds


Upcoming CME Conferences


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue.

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Platform for Vancomycin Measurements to Change

The Department of Pathology and Laboratory Medicine will be changing platforms for vancomycin measurement beginning Tuesday, Aug. 1.

Vancomycin is being moved from a Beckman AU680 platform to redundant Roche P Modules in order to provide backup of instrumentation when maintenance issues arise. In addition, the recommended therapeutic intervals are being updated so they will be in line with the most recent guidelines for efficacy.

Also, please note that the validated specimen type will change from lithium heparin plasma to serum. The toxic value, the point where providers are contacted, will remain at 20 mg/L. (This change is temporary as the transition to new Abbott platforms occurs around September.)


Vancomycin Therapeutic Interval
Beckman Assay (current)
PLASMA (Lithium Heparin & EDTA) and SERUM
Roche Assay (new)
SERUM ONLY
Trough 5-10 mg/L

10-20 mg/L

General therapeutic goals for trough vancomycin are as follows: 10-15 mcg/mL for uncomplicated infections and 15-20 mcg/mL for more complicated infections.

References: Cedars-Sinai antiomicrobial stewardship committee Vancomycin Procedure and American Journal of Health-System Pharmacy January 2009,66 (1) 82-98.

Peak 30-40 mg/L 25-40 mg/L

Evaluating trough vancomycin levels are the most accurate and practical method for monitoring efficacy. Despite a range being provided, monitoring of peak vancomycin levels is often not clinically indicated.


If you have questions, please contact Kimia Sobhani, PhD, at kimia.sobhani@cshs.org.