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Guidelines for Therapeutic Drug Monitoring of Vancomycin: A Systematic Review

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  • Zhi-Kang Ye
  • Can Li
  • Suo-Di Zhai

Abstract

Background and Objective: Despite the availability of clinical practice guidelines (CPGs) for therapeutic drug monitoring (TDM) of vancomycin, vancomycin serum concentrations still do not reach therapeutic concentrations in many patients. Thus, we sought to systematically review the quality and consistency of recommendations for an international cohort of CPGs regarding vancomycin TDM. Methods: PubMed, Embase, guidelines' websites and Google were searched for CPGs for vancomycin TDM. Two independent assessors rated the quality of each CPG using the Appraisal of Guidelines for Research & Evaluation II (AGREEII) instrument and data were independently extracted. Results: Twelve guidelines were evaluated and the overall quality of guidelines for vancomycin TDM was moderate. The highest score was recorded in the domain of clarity of presentation, and the lowest score was recorded in the domain of rigor of development and stakeholder involvement. The specific recommendations for vancomycin TDM were moderately consistent and guidelines varied in trough concentration monitoring, frequency of TDM, and serum concentration targets. Conclusion: The overall guideline quality for vancomycin TDM was not optimal and effort is needed to improve guideline quality, especially in the domain of rigor of development and stakeholder involvement.

Suggested Citation

  • Zhi-Kang Ye & Can Li & Suo-Di Zhai, 2014. "Guidelines for Therapeutic Drug Monitoring of Vancomycin: A Systematic Review," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0099044
    DOI: 10.1371/journal.pone.0099044
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    References listed on IDEAS

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    1. Haley K Holmer & Lauren A Ogden & Brittany U Burda & Susan L Norris, 2013. "Quality of Clinical Practice Guidelines for Glycemic Control in Type 2 Diabetes Mellitus," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-6, April.
    2. Zhi-Kang Ye & Hui-Lin Tang & Suo-Di Zhai, 2013. "Benefits of Therapeutic Drug Monitoring of Vancomycin: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-10, October.
    3. Susan L Norris & Haley K Holmer & Lauren A Ogden & Brittany U Burda & Rongwei Fu, 2013. "Conflicts of Interest among Authors of Clinical Practice Guidelines for Glycemic Control in Type 2 Diabetes Mellitus," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.
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