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Guidelines
Definitions Associated with Criteria for Use for Anti-MRSA Agents

Definitions Associated with Criteria for Use for Anti-MRSA Agents

Definitions

  • Clinical decompensation or worsening signs and symptoms of infection (i.e. fever, leukocytosis) while on vancomycin therapy for at least 72 hours

  • Development of acute kidney injury (AKI) at any time while on vancomycin therapy

  • Inability to achieve therapeutic levels of vancomycin due to increased clearance or suboptimal clearance (must have documented levels to confirm this)

  • Repeat positive cultures despite adequate documented vancomycin trough/random levels

    • Ensure timing of levels are done appropriately

True vancomycin allergy:

  • Vancomycin infusion reaction is not a true vancomycin allergy and is not a contraindication to vancomycin therapy, rather the rate of infusion should be extended
  • Patient's should be interviewed about allergies and reactions documented/updated in Cerner

  • AKI upon admission

    • CKD must be differentiated from AKI as stable CKD patients can be dosed with vancomycin therapy via pulse dosing/random levels
    • Once AKI resolves, regimens should be re-reviewed and first line alternatives should be considered

  • Morbid obesity

    • Class Ill obesity (BMI ≥ 40 kg/m2) or > 140% of IBW