How important are vancomycin levels? Not very…. at least as a marker of efficacy. True, higher levels probably are associated with increased nephrotoxicity (above 15 mcg/mL) – Antimicrob Agents Chemother. 2013 ;57:734-44 But the notion that troughs of 15-20 mcg/mL are the holy grail of therapeutic drug monitoring targets is simply not supported by data.… Read More

Obviously any patient that requires mechanical ventilation for 48 hours or has “coagulopathy” should get stress ulcer prophylaxis (SUP) right? maybe not…. when the above risk factors where identified in 1994 by Deborah Cook (N Engl J Med. 1994;330(6):377-81.) and studies validating SUP as an effective means of preventing GI bleeding in critically ill patients… Read More

I frequently encounter people touting that “The INR of FFP is like 1.6 or something”. Indeed I learned something similar myself at some point. It turns out however that the mean INR of FFP is actually 1.1 (Transfusion 2005;45:1234-5.). So why does it seem like no matter how much FFP you tend to give, it… Read More