Youssef et al. make a strong case for addressing 25(OH)D concentration (vitamin D status) in hospitalized patients with infections.
Dermatoendocrinol. 2012 Apr 1; 4(2): 84.
doi: 10.4161/derm.20272
PMCID: PMC3427204
PMID: 22928062
Youssef et al. make a strong case for addressing 25(OH)D concentration (vitamin D status) in hospitalized patients with infections
David McCarthy*
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Independent Contractor; Ofallon, IL USA
*Correspondence to: David McCarthy, Email: moc.oohay@42fasucamd
Copyright © 2012 Landes Bioscience
This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.
See commentary "Antimicrobial implications of vitamin D" in volume 3 on page 220.
This article has been cited by other articles in PMC.
Abstract
Correcting vitamin D deficiency in the outpatient setting has become commonplace and is a routine in many primary care practices. This extension into the inpatient setting is timely and logical. The benefits of vitamin D testing continue to be demonstrated.
There are several steps that health care providers can take to assure this approach is possible: (1) arrange for rapid processing of 25-hydroxyvitamin D [25(OH)D] and serum calcium specimens; (2) gain approval from the hospital pharmacy and therapeutics committee to stock 5,000 IU vitamin D capsules; (3) identify key staff physicians to provide consultative expertise in the rapid repletion of vitamin D in septic patients; (4) identify key pharmacists who can support provider and nursing education as well as patient specific therapeutic efforts; (5) identify key nurses to educate staff in the ER, ICU and ward settings; (6) consider notifying providers of vitamin D status, if known, at the time antibiotics or anti-viral agents are ordered; (7) correlate mortality data with vitamin D status in hospital-wide, blinded, non-judgmental communications; (8) correlate cost and length of stay data with vitamin D status in patients with infections; (9) consider addressing vitamin D status in patients at the time of scheduling for elective surgeries.
Capsules of 50,000 IU vitamin D3 are available (e.g., Biotech Pharmacal) and can be given to patients with very low serum 25-hydroxyvitamin D concentrations.
Self-education is available at vitamindcouncil.com. Vitamin D conferences have been available at several sites in North America and Europe.
Having practiced as a family physician for 25 y using the standard vitamin D dose of 400 IU and five years using vitamin D dosing sufficient to give blood levels > 50 ng/ml (> 120 nmoles/ml), I will never return to the “inky dinky dose” again.
Notes
Youssef DA, Miller CW, El-Abbassi AM, Cutchins DC, Cutchins C, Grant WB, et al. Antimicrobial implications of vitamin D Dermatoendocrinol 2011 3 220 9 doi: 10.4161/derm.3.4.15027.
Footnotes
Previously published online: www.landesbioscience.com/journals/dermatoendocrinology/article/20272
References
1. Bailey BA, Manning T, Peiris AN. Vitamin D testing patterns among six Veterans Medical Centers in the southeastern United States: links with medical costs. Mil Med. 2012;177:70–6. [PubMed] [Google Scholar]
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