Date of Award

Spring 2023

Degree Type



College of Pharmacy

Director of Thesis

Dr. Brandon Bookstaver

First Reader

Dr. Melissa Nolan

Second Reader

Dr. Melissa Nolan


Vancomycin is a mainstay of therapy for treating virulent and resistant infections, especially methicillin-resistant Staphylococcus aureus (MRSA). However, vancomycin requires therapeutic drug monitoring (TDM) for optimal dosing and treatment. This requires pharmacists to calculate a dosing regimen that correlates to appropriate goal vancomycin concentrations in the blood. Dosing vancomycin can be difficult, as it varies on a patient’s weight, renal function, age, etc. Doses may have to be adjusted in response to out-of-range concentrations, which requires further pharmacy calculations. Inaccurate dosing poses a risk to patient safety and places a resource and time burden on pharmacists. If vancomycin dosing methods do not prove to correlate with patient safety goals and therefore require further pharmacist intervention, then alternative antibiotic regimens could be considered. This article reviews the real-world accuracy of vancomycin dosing, the burden this dosing places on pharmacists, and the alternative antibiotics that may be used to replace vancomycin for certain indications.

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© 2023, Kateryna Parkhomenko