title: Why monitor peak vancomycin concentrations?
abstract: Peak and trough serum concentrations are routinely measured to monitor vancomycin therapy. Optimal therapy depends upon maintaining a concentration above that necessary for antibacterial activity and is therefore determined by the trough concentration. I determined the post dose increases in serum drug concentrations in routine clinical practice in adult patients without renal failure. Mean increases of 16.6 mg/L (SD 6.1) (peak samples collected 1 h post infusion) were measured from 165 paired samples. The results suggest that as long as trough concentrations do not exceed 15 mg/L, peak levels will not exceed normally accepted safe concentrations, and therefore do not need to be measured.
authors.affiliation: Department of Infectious Diseases and Bacteriology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Saunders
mesh_terms: D000328:Adult; D000368:Aged; D016903:Drug Monitoring; D006801:Humans; D011446:Prospective Studies; D014640:Vancomycin / Q000008:administration & dosage / Q000097:blood*
chemical_list: D014640:Vancomycin