title: Continuous intravenous administration of vancomycin in medical intensive care unit patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate continuous vancomycin infusion (contV) in intensive care unit patients.
  
  
  METHODS
  A retrospective study in 164 patients treated with contV was conducted. They were compared with 75 patients treated with intermittent vancomycin infusion.
  
  
  RESULTS
  The median duration of vancomycin therapy in the contV group was 6 (5%-95% percentile range, 2-21) days. The median daily vancomycin dose in the contV group was 960 (526-1723) mg, resulting in a median serum vancomycin plateau concentration of 19.8 (9.8-29.4) mg/L (target: 15-25 mg/L). The contV administration regime was sufficient regarding achievement of the target serum vancomycin concentration. However, in the contV group, serum vancomycin levels were frequently in a subtherapeutic range on treatment days 1 (44%), 2 (29%), and 3 (23%). In the contV group, serum vancomycin concentration determinations per treatment day were performed significantly less often compared with the intermittent vancomycin infusion group (0.38 [0.15-0.75] vs 0.43 [0.22-1.00], P = .041).
  
  
  CONCLUSIONS
  In medical intensive care unit patients, contV is sufficient to achieve target serum vancomycin concentrations. Because contV frequently resulted in subtherapeutic drug levels on the first days of therapy, a higher loading or starting dose might be necessary.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, D-81675 München, Germany. bcs.muc@gmx.de
authors.forename: Bernd
authors.initials: B
authors.lastname: Saugel
authors.forename: Marisa C M
authors.initials: MC
authors.lastname: Nowack
authors.forename: Alexander
authors.initials: A
authors.lastname: Hapfelmeier
authors.forename: Andreas
authors.initials: A
authors.lastname: Umgelter
authors.forename: Caroline
authors.initials: C
authors.lastname: Schultheiss
authors.forename: Philipp
authors.initials: P
authors.lastname: Thies
authors.forename: Veit
authors.initials: V
authors.lastname: Phillip
authors.forename: Florian
authors.initials: F
authors.lastname: Eyer
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Huber
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D019540:Area Under Curve; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D005260:Female; D005858:Germany; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy*; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin