title: [Monitoring vancomycin in an intensive care unit: A retrospective survey on 66 patients].
abstract: OBJECTIVE
  The study objectives were to check whether recommended vancomycin doses were related to pharmacological objectives for intensive care patients: steady-state plasma concentration (SSc) and ratio SSc/MIC (Minimal Inhibiting Concentration). The authors tried to identify variability factors for vancomycin plasmatic concentrations at peak.
  
  
  METHODS
  This monocentric, observational, and retrospective survey was performed on 66 intensive care patients treated by antibiotics including vancomycin, alone or in combination, as a curative treatment for a severe infection with Gram-positive bacteria. Vancomycin was dosed at 15mg/kg during the first hour, then 40 to 60mg/kg per 24hour. Vancomycin SSc and bacteria MIC were recorded. The SSc/MIC ratio was determined and was considered efficient when superior to 8.
  
  
  RESULTS
  Forty-two percent of vancomycin SSc were within the effectiveness rate. Twenty-three percent of SSc/MIC ratios were superior to 8. The rate of clinical recovery was 71 %. The length of antibiotherapy was identified as positively interacting with biological effectiveness, unlike severe sepsis, a factor of negative interaction on vancomycin SSc in this study.
  
  
  CONCLUSIONS
  Less than half of the SSc and less than a quarter of the SSc/MIC ratios were at effective rates in our study. Therefore, adequacy between dosage, administration, and monitoring should be reviewed.
authors: Fédération d'anesthésie-réanimation-urgences, hôpital d'instruction des armées Clermont-Tonnerre, BCRM de Brest, CC 41, 29240 Brest cedex 9, France. diane.commandeur@wanadoo.fr
authors: D
authors: D
authors: Commandeur
authors: C
authors: C
authors: Giacardi
authors: M
authors: M
authors: Danguy Des Deserts
authors: S
authors: S
authors: Huynh
authors: M L
authors: ML
authors: Buguet-Brown
authors: M
authors: M
authors: Ould-Ahmed
authors: I
authors: I
authors: Drouillard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin