Monitoring of vancomycin serum levels for the treatment of staphylococcal infections.
Vancomycin serum concentrations were determined for 1,737 patients treated with either 2 x 1 g of vancomycin or 4 x 500 mg daily (780 patients), according to current nomograms, or by continuous infusion (957 patients) with a loading dose (1 g) and a total of 2-6 g daily. Trough serum concentrations were determined after 36-48 h. Adequate serum levels for the treatment of a normal methicillin-resistant Staphylococcus aureus (MRSA) and a glycopeptide-intermediate S. aureus (GISA) were observed in 81% and 20.9% of patients, respectively. The data support theoretical arguments that higher and more sustained serum levels of vancomycin, obtained by continuous infusion, may enhance clinical efficacy.
Kitzis
M D
MD
Clinical Microbiology Laboratory, Hospital Saint Joseph, 75014 Paris, France.
Goldstein
F W
FW
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D006020:Glycopeptides / Q000494:pharmacology; D006801:Humans; D007262:Infusions, Intravenous; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D014640:Vancomycin / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D014640:Vancomycin