The Northern Health (NH) Antimicrobial Stewardship Program has developed two new regional order sets to help you with initial dosing of vancomycin and aminoglycosides for adult inpatients. These order sets were approved for use by the NH Medical Advisory Committee. They can be used at all inpatient facilities in NH.
These order sets will assist with initial dosing and monitoring until a pharmacist is available. NH pharmacists will provide follow-up for ongoing maintenance dosing and monitoring following procedures outlined in NH clinical practice standard 1-20-6-1-100.
For sites without weekend and holiday pharmacist coverage, the UHNBC pharmacy can provide service through the dispensary, or the pharmacist on call if it’s outside the UHNBC pharmacy hours of operation.
Initiation of Vancomycin for Adult Inpatients (Order Set 10-111-5335):
- Dose banding table for loading dose and initial maintenance dose based on total body weight
- Initial dosing interval based on estimated (calculated) creatinine clearance
- Orders for initial labs for monitoring
Initiation of Aminoglycosides for Adult Inpatients (Order Set 10-111-5336):
- Information on high-dose extended-interval dosing and conventional (multiple daily dose) dosing
- Calculations for dosing based on patient weight (usually based on ideal body weight, but see order set for additional information on patients who are underweight or obese).
- Initial dosing interval based on estimated (calculated) creatinine clearance
- Orders for initial labs for monitoring
The order sets can be printed from Document Source and are also posted on the NH physicians website in the Antimicrobial Stewardship section.
Questions? Contact Ryan Doerksen, Interim AMS Program Coordinator, at ryan.doerksen@northernhealth.ca.