[Continuous and intermittent infusion of vancomycin equally effective: review of the literature].
OBJECTIVE
To compare the efficacy of continuous vancomycin infusion with intermittent vancomycin infusion based on clinical endpoints.


METHODS
Systematic review of the literature.


METHODS
Sixty articles on comparative studies on continuous and intermittent vancomycin infusion were found in Pubmed. Of these, the English-language articles on studies in adults were selected. Only articles in which a comparison was made in terms of clinical endpoints were included.


RESULTS
Six studies were included in which the differences between continuous and intermittent infusions were assessed in terms of the clinical endpoints. In the 2 prospective studies, no statistically significant differences in efficacy between the two methods of administration were found. A prospective study and retrospective study suggested that continuous infusion of high-dose vancomycin in patients with osteomyelitis may be more effective than intermittent infusion. There were no clear differences in side effects, although nephrotoxicity seemed to occur less rapidly and less often with continuous vancomycin infusion.


CONCLUSIONS
The available literature showed that continuous infusion of vancomycin is as effective as intermittent administration. In addition, continuous administration is cheaper and monitoring of serum levels is simpler. This offers the possibility of discharging specific patients more quickly from hospital and facilitates home care with vancomycin.
Universitair Medisch Centrum Utrecht, Ziekenhuisapotheek, Utrecht, the Netherlands. e.m.vanmaarseveen@umcutrecht.nl
Erik M
EM
van Maarseveen
Wai Hong
WH
Man
Daan J
DJ
Touw
Annemien W
AW
Bouma
Arthur R H
AR
van Zanten
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents; D014640:Vancomycin