1294. A survey on Vancomycin and Beta Lactams usage in critical care settings in Makkah, Kingdom of Saudi Arabia

Abstract

BackgroundDrug pharmacokinetics/pharmacodynamics (pk/PD) play a vital role in the dose optimization of antimicrobials to maintain targeted effective plasma concentration. Pharmacokinetics parameters e.g., Volume of distribution, clearance, half-life are highly variable in Critically ill patients, therefore require a patient-specific approach to maximize antimicrobials’ clinical effectiveness.The percentage of the dosing interval to ensure free plasma concentration more then MIC is an evidence-based approach to achieve pharmacodynamic targets among critically ill patients. Therefore, using Extended and continuous infusions of Vancomycin and Beta lactams will optimize therapy by promising more time for free plasma concentration above MIC in treatment.MethodsA self-administered survey was distributed during morning meeting to intensivists to record their attitude and practice towards Vancomycin and Beta lactams usage in intensive care units. The regional institutional review board approved the study of the ministry of health, Makkah, Saudi Arabia.ResultsThe response rate was 95 %, as the survey was distributed electronically before the dose optimization workshop conducted at each hospital. The majority (72.5 %) of the intensivists were using only extended infusion for Meropenem in practice. Interestingly, none of the hospitals was familiar with the pk/PD target for vancomycin dosing. Further, most of the intensivists (65 %) were unfamiliar with continuous/extended infusion strategy for Vancomycin in their practice. The majority of them were using traditional trough level target by utilizing standard dosing.ConclusionThis survey concludes the requirement of a dose optimization policy for beta-lactam and vancomycin in critical settings by utilizing extended/continuous infusion.Disclosures All Authors: No reported disclosures