Romanian Society of Pharmaceutical Sciences
 

« Back to Farmacia Journal 4/2025

CLINICAL PHARMACIST LED THERAPEUTIC DRUG MONITORING FOR VANCOMYCIN IN A ROMANIAN HOSPITAL

LIGIA-ANCUȚA HUI 1,2, CONSTANTIN BODOLEA 2,3, ANA-MARIA VLASE 4, ELISABETA IOANA HIRIȘCĂU 2,5, ANDREI-MIHAI BĂLAN 2,3, LAURIAN VLASE 1*, ADINA POPA 6

1 Pharmaceutical Technology and Biopharmacy Department, Faculty of Pharmacy, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
2 ICU Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
3 ICU II Department, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006, Cluj-Napoca, Romania
4 Pharmaceutical Botany Department, Faculty of Pharmacy, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
5 Nursing Department, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400089, Cluj-Napoca, Romania
6 Clinical Pharmacy Department, Faculty of Pharmacy, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania

Download Full Article PDF

Vancomycin is an antibiotic active against methicillin-resistant Staphylococcus aureus infection. It has a narrow therapeutic index, and the bacterial resistance is increasing which brings efficacy and safety concerns. To overcome these, it is recommended that therapeutic drug monitoring (TDM) to be performed, but it is still not implemented in Romania. This is a pilot study initiated by the clinical pharmacist in an intensive care unit to highlight the TDM benefits. The objective of the retrospective, open-label, single-centre study conducted in a Romanian hospital was to analyse the pharmacokinetics and pharmacodynamics of vancomycin using TDM, to compare the frequency of renal function impartment in patients with TDM versus patients without TDM and to evaluate the clinical pharmacist’s role in managing ICU patients receiving vancomycin. In 62% of cases, the prescribed dose did not produce adequate serum concentrations, and TDM played a crucial role in managing these patients. A 34% reduction in the incidence of renal impairment was achieved through clinical pharmacist-led TDM for vancomycin. It is essential for Romanian hospitals to involve clinical pharmacists in the care of ICU patients and to implement TDM as a standard practice to improve care quality.