I am a professor and attending pharmacist in the field of pharmaceutical sciences and writer or co-author of at least 5 manuscripts about different aspects of COVID-19. More than 15 months from the first report of COVID-19, over 120 million people all over the world infected by this virus, and more than 2.5 million of them have died. Although different treatment approaches have been proposed, management of the COVID-19 patients is steal remained controversial. In this regard, I want to share my personal experience from the exposure to the coronavirus and the consequence of this infection on my health status. I am a 51 years old male, known case of hypertension, dyslipidemia, and chronic kidney disease. During working hours of colleagues in the Faculty of Pharmacy, I visited one of my colleagues in his office. After leaving the Faculty, my colleague declares that his RT-PCR test of COVID-19 is positive and it took 3 days for me to experience the first sign of the COVID-19 as fever. Many complications have occurred for me during the different stages of COVID-19 infection that I shared and explained in detail with the suggested pharmacotherapies. According to the pathophysiology of COVID-19 infection and my personal experience during COVID-19 infection, I want to emphasize the necessity of early initiation of anti-inflammatory agents including corticosteroids and colchicine in high-risk patients with mild-to-moderate COVID-19 pneumonia who shows respiratory system involvement, in order to prevent progression to the severe and critical stages of this disease.

I am a professor and attending pharmacist in the field of pharmaceutical sciences and writer or co-author of at least 5 manuscripts about different aspects of COVID-19. More than 15 months from the first report of COVID-19, over 120 million people all over the world infected by this virus, and more than 2.5 million of them have died. Although different treatment approaches have been proposed, management of the COVID-19 patients is steal remained controversial. In this regard, I want to share my personal experience from the exposure to the coronavirus and the consequence of this infection on my health status. I am a 51 years old male, known case of hypertension, dyslipidemia, and chronic kidney disease. During working hours of colleagues in the Faculty of Pharmacy, I visited one of my colleagues in his office. After leaving the Faculty, my colleague declares that his RT-PCR test of COVID-19 is positive and it took 3 days for me to experience the first sign of the COVID-19 as fever. Many complications have occurred for me during the different stages of COVID-19 infection that I shared and explained in detail with the suggested pharmacotherapies. According to the pathophysiology of COVID-19 infection and my personal experience during COVID-19 infection, I want to emphasize the necessity of early initiation of anti-inflammatory agents including corticosteroids and colchicine in high-risk patients with mild-to-moderate COVID-19 pneumonia who shows respiratory system involvement, in order to prevent progression to the severe and critical stages of this disease.

Introduction: Vancomycin is a glycopeptide antibiotic that is considered as the drug of choice against many Gram-positive bacterial infections, especially Methicillin-resistant Staphylococcus aureus (MRSA). Also, it is a hydrophilic drug with predominantly renal elimination. Given the vancomycin narrow therapeutic index, therapeutic drug monitoring (TDM) is essential to achieve an optimum clinical response and avoid vancomycin-induced adverse drug reactions including nephrotoxicity and ototoxicity. Although different studies are available on vancomycin pharmacokinetic assessment and vancomycin TDM, still there are controversies regarding the selection among different pharmacokinetic parameters including trough concentration (Cmin), the daily area under the curve to minimum inhibitory concentration (AUC24h/MIC) ratio, AUC of intervals (AUCτ), elimination constant (k), vancomycin clearance (ClV) and methods of their calculations for TDM purposes. Methods: In this review, different pharmacokinetic parameters for vancomycin TDM have been discussed in detail along with corresponding advantages and disadvantages, based on the literature review. Determination of vancomycin concentration at steady state (Css) during 24h continuous injection are mentioned. Also, vancomycin pharmacokinetic assessments are discussed in detail in patients with altered pharmacokinetic parameters including those with renal and/or hepatic failure, critically ill patients, patients with burn injuries, intravenous (IV) drug users, obese and morbidly obese patients, those with cancer, patients undergoing organ transplantation, and vancomycin administration during pregnancy and lactation. Results and Discussion: An individualized dosing regimen is required to guarantee the optimum therapeutic results and minimize severe adverse reactions such as acute kidney injury (AKI) in these special groups of patients with altered pharmacokinetic parameters. Also, according to the pharmacoeconomic data on vancomycin TDM, pharmacokinetic assessments would be cost-effective in the mentioned groups of patients with altered pharmacokinetics and associated with shorter hospitalization period, faster clinical stability status, and shorter courses of inpatient vancomycin administration.