4CPS-035 Clinical pharmacokinetics of vancomycin in neutropenic patients

Background and importanceAccording to the study by Bury D et al,1 vancomycin dosage should be 25% higher than standard dosages in neutropenic patients due to increased clearance of vancomycin in this population. Renal hyperfiltration is considered a possible mechanism.Aim and objectivesWe aimed to determine the prevalence of subtherapeutic drug exposure in neutropenic patients under therapeutic drug monitoring (TDM) and the subsequent TDM dosage adjustments.Material and methodsThis was a retrospective and descriptive study from 2010 to 2019. Patients with haematological disease with neutropenia and receiving vancomycin TDM by pharmacists were included. Demographic variables, Cockcroft–Gault creatinine clearance (CrCl), initial dosage, dose adjustments and the first two trough levels were collected. Renal impairment was defined as CrCl