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Therapeutic drug monitoring of vancomycin in patients receiving haemodialysis: time for a change
  1. F Fitzpatrick,
  2. T McGaley,
  3. L Rajan,
  4. R Crowley,
  5. M Turley,
  6. H Humphreys,
  7. E Smyth
  1. Department of Microbiology, Beaumont Hospital, Dublin, Republic of Ireland
  1. Correspondence to:
    F Fitzpatrik
    Department of Microbiology, Beaumont Hospital, Dublin, Republic of Ireland; fidelmafitz{at}

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A polyclonal antibody-based fluorescence polarisation immunoassays (pFPIA) overestimates vancomycin levels in the serum of patients receiving haemodialysis.1 Prolonged exposure of vancomycin to body temperature in these patients allows vancomycin to break down into crystalline degradation products (CDP-1).2 Because of structural similarities between vancomycin and CDP-1, a pFPIA may falsely recognise and report CDP-1 as vancomycin. Despite this, most laboratories in the UK and in the Republic of Ireland, including ours, continue to use a pFPIA for therapeutic drug monitoring (TDM) of vancomycin.3 We wish to bring this issue to the attention of laboratories, as therapeutic decisions on the basis of levels that are falsely recognised as increased …

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  • Competing interests: None declared.