title: Continuous infusion of vancomycin in methicillin-resistant staphylococcus infection.
abstract: OBJECTIVE
  The aim of the study was to verify the therapeutic response of vancomycin in methicillin-resistant staphylococcus infection (MRSA/ MRCNS) administered according to two different methods (intermittent infusion vs. continuous infusion).
  
  
  METHODS
  Experimental plan: retrospective study; study environment: university hospital, two intensive care units. Twenty-five critically ill patients submitted to antibiotic treatment with vancomycin for infection from MRSA/MRCNS were studied. The patients, who were classified according to SAPS II scores, were divided into two groups: group A (n = 14): dose of vancomycin of 0.5 g x 4/day and group B (n = 11): dose of 2 g/day of vancomycin administered in a continuous infusion. Before the antibiotic therapy was started (T1) and prior to its end (T2), the following parameters were evaluated: degree of impairment of the main organs and systems by means of sepsis-related organ failure assessment score (SOFA) and count of the white blood cells (WBC). The length of the hospital stay during intensive care was calculated for both groups (statistics: Student t test).
  
  
  RESULTS
  No significant differences were found in the SAPS II scores and in the length of the hospital stay. In a comparison of the T1 and T2 results, we noted that patients of group A had no variations in the SOFA scores (4.84 +/- 2.48 vs. 4 +/- 3.9) and in the WBC mean values (12,415 +/- 5,099 vs. 12,841 +/- 6,864 cells/mm3). In contrast, in the patients of group B, we noted significant variations (p < 0.05) in the mean values of the SOFA scores (6.62 +/- 2.2 vs. 4.37 +/- 3.5) and in the mean values relative to the WBC count (17,242 +/- 12,842 vs. 10,757 +/- 3,610 cells/mm3).
  
  
  CONCLUSIONS
  In critically ill patients suffering from MRSA/MRCNS infection, vancomycin administration in continuous infusions improved organ function and leukocyte response, but did not seem to modify the overall evolution of the disease.
authors.affiliation: Institute of Anesthesiology and Intensive Care, University of Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Filippo
authors.forename: A R
authors.initials: AR
authors.lastname: De Gaudio
authors.forename: A
authors.initials: A
authors.lastname: Novelli
authors.forename: E
authors.initials: E
authors.lastname: Paternostro
authors.forename: C
authors.initials: C
authors.lastname: Pelagatti
authors.forename: P
authors.initials: P
authors.lastname: Livi
authors.forename: G P
authors.initials: GP
authors.lastname: Novelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin