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Vancomycin: How might Urinary Biomarkers and Precision Dosing create Precision Medicine for the most frequently utilized antibiotic in the hospital?

C.E. Credits: P.A.C.E. CE Florida CE
Speaker
  • Professor, Midwestern University in the Chicago College of Pharmacy, Director of the Pharmacometric Center of Excellence at Midwestern University
    Biography
      Marc Scheetz attained a Doctorate of Pharmacy from Butler University, earned a Masters of Science in Clinical Investigation degree at Northwestern University, and completed his pharmacy practice residency and an infectious diseases fellowship at Northwestern Memorial Hospital. Dr. Scheetz is a Professor at Midwestern University in the Chicago College of Pharmacy and holds a joint appointment in the Department of Pharmacology, College of Graduate Studies. Dr. Scheetz is the Director of the Pharmacometric Center of Excellence at Midwestern University. He currently practices clinically as an infectious diseases pharmacist at Northwestern Memorial Hospital in downtown Chicago, IL and serves as the Director for the Post-Doctoral Fellowship Program in Infectious Diseases Pharmacotherapy.

      Dr. Scheetz has authored a number of original research manuscripts and review articles in the area of anti-infective pharmacokinetics and pharmacodynamics and currently serves as a reviewer for several infectious diseases, pharmacy, and medical journals. His primary research interest lies in the interface of the pharmacokinetic/pharmacodynamic interaction (i.e. between antimicrobials, pathogens, and hosts). He is particularly interested in assessing modifiable pharmacologic variables in the treatment of infectious diseases and identifying optimal exposures against the backdrop of toxicity. His group studies toxicology in the laboratory as well as through clinical data modeling. Dr. Scheetz is actively engaged in local and national leadership positions and formerly served as a member of the FDA Antimicrobial Drugs Advisory Committee.

    Abstract

    In the United States, vancomycin is the single most commonly prescribed antibiotic in the hospital setting and is a well-known nephrotoxin. Despite over 60 years of clinical use, there is still debate on the drivers, modifiers, and time-course of the kidney injury associated with vancomycin. Drug-induced kidney injury results in significant long term patient morbidity and mortality. Meanwhile, clinical trials are difficult and expensive, with an estimated median cost of $40,000 USD per enrolled patient. Thus, human trials are less frequently performed. Preclinical models and newer urinary biomarkers provide a feasible pathway to creating safer vancomycin treatment courses for patients. Positive findings can be carried forward to create Precision Dosing for vancomycin (i.e. drug optimization based on individual patient exposures and biomarkers that indicate sub-clinical toxicity).

    Learning Objectives:

    1. Describe the exposure-response relationships with vancomycin and acute kidney injury
    2. Define biomarkers that may be useful to improve Precision Dosing


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