First do no harm. These words are the battle cry for many of us, but took on an sense of urgency ever since the Institute of Medicine published “To Err Is Human” in 1999. This famous report launched the modern patient safety movement and shined a spotlight on the shocking number of medical errors occurring every day in our hospitals. The IOM estimated that between 44,000 and 98,000 fatal medical errors occurred annually in the US. Drug dosing errors accounted for nearly half of these medical errors.
One study found that in elderly patients with chronic kidney disease, antibiotic dosing errors occurred in 64/100 prescriptions. Another study found that antibiotic dosing errors accounted for over 40% of all medication errors. Vancomycin is one of our most potent and frequently lifesaving antibiotics. It is frequently the empiric antibiotic of choice for meningitis, sepsis, endocarditis, osteomyelitis, and complicated skin and soft tissue infections. It is the drug of choice against methicillin-resistant Staph aureus. However, vancomycin is almost entirely renally eliminated and dosing errors (and even proper dosing) is associated with acute kidney injury, ototoxicity and neutropenia. Proper dosing is key and online and other point of care tools have been shown to reduce dosing errors with vancomycin. ClinCalc.com sponsors one popular online vancomycin dosing calculator. They also have a mobile version of their online medical calculator simply called, Vancomycin Calculator.
Here on iMedicalApps we previously reviewed DoseAdjust, another vancomycin dosing calculator, but found it too cumbersome for those without knowledge of the parameters needed for safe dosing of the drug. Vancomycin Calculator offers a step by step process for pharmacists and physicians wanting to ensure proper vancomycin dosing in a variety of situations.
Evidence based medicine
The Vancomycin calculator medical app is the mobile version of an established and respected website containing an easy to use vancomycin calculator among other clinical calculators. The medical app describes in detail the kinetics and basis of vancomycin dosing. No references are provided on the medical app, but are available on the website of the online calculator.
Who would benefit from this Medical App?
Pharmacists and pharmacy students, nurses, residents, primary care providers, emergency medicine, internal medicine and critical care, any provider who prescribes vancomycin.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Simple to use interface with excellent detail on calculator results and numerous settings.
- Robust material on kinetics for vancomycin and basis for various settings.
- Information about the medial app developers and ability to provide feedback.
- Demystifies the process of properly dosing vancomycin.
- Price may be too high for some who will prefer the “free” website calculator.
- No references (they are available on the ClinCalc website)
- App would benefit from short video showing initial and follow-up trough calculations.
- No ability to maintain data on multiple patients.
Vancomycin Calculator by ClinCalc is an outstanding “mobile” version of their excellent website calculator. The Vancomycin calculator app works just as well as the website and allows for calculations in the bowels of the hospital without cellular or Wi-Fi connectivity. For many, the website version will suffice, but the app works as advertised. The medical app is an excellent “check and balance” for staff overseeing trainees and to check your own orders.
- Overall Score
- User Interface
Great interface design and ease of use with excellent information about the use of the medical app.
- Multimedia Usage
Medical App has links to the ClinCalc website for additional clinical calculators. No ability to save multiple patient calculations or links to references.
Medical App is $2.99, reasonable, but ClinCalc website has same calculator for free.
- Real World Applicability
This is a medical app I use every time I am the ward attending and want to double check the vancomycin orders the resident entered and discussed with the inpatient pharmacist. It is the app used by pharmacists in our own facility. This is definitely an app pharmacists working with inpatient and critical care teams should take a look at as well as providers who want to ensure proper dosing of this valuable but potentially toxic antibiotic. Everyone should bookmark the ClinCalc website for sure.
- Device Used For Review
iPhone 6S running iOS 9.2.1
- Available for DownloadAndroidiPhoneiPad