Once-daily versus twice-daily intravenous administration of vancomycin for infections in hospitalized patients.
The efficacy and toxicity of once-daily (od) versus twice-daily (bd) dosing of vancomycin was compared in 121 hospitalized patients. Eighteen patients were then withdrawn from the study. Clinical and bacteriological responses were evaluated in all patients (n = 103). Nephrotoxicity was assessed in patients who did not receive nephrotoxic agents (n = 76). Ototoxicity was assessed in patients who completed two audiograms and were not receiving ototoxic agents (n = 63). No significant difference was found between the two groups for favourable clinical response: 47/51 (92.1%) and 49/52 (94.2%) in the od and bd groups, respectively. In 34 patients vancomycin was the only effective antibiotic. Fifteen of 18 (83.3%) evaluated episodes in the od and 12/16 (75.0%) evaluated episodes in the bd group showed a favourable bacteriological response. There were no significant differences between the od and bd groups for all adverse events. Nephrotoxicity developed in 4/37 (10.8%) and 3/39 (7.7%) patients, respectively. Hearing loss developed in 1/31 (3.2%) and 5/32 (15.6%). Phlebitis occurred in 7/51 (13.7%) and 12/52 (23.0%). Red man syndrome occurred in 7/51 (13.7%) and 5/52 (9.6%) in od and bd groups, respectively. The efficacy and safety profile of od administration of vancomycin is similar to that of the customary, but less convenient, bd administration.
Cohen
Eytan
E
Recanati Centre for Medicine and Research and Clinical Pharmacology Unit, Rabin Medical Center, Beilinson Campus, Petach-Tikva, Israel.
Dadashev
Alexander
A
Drucker
Moshe
M
Samra
Zmira
Z
Rubinstein
Ethan
E
Garty
Moshe
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D014640:Vancomycin