title: Continuous versus intermittent infusion of vancomycin in adult patients: A systematic review and meta-analysis.
abstract: Continuous infusion of vancomycin (CIV) and intermittent infusion of vancomycin (IIV) are two major administration strategies in clinical settings. However, previous articles comparing the efficacy and safety of CIV versus IIV showed inconsistent results. Therefore, a meta-analysis was conducted to compare the efficacy and safety of CIV and IIV. PubMed, the Cochrane Library and Web of Science up to June 2015 were searched using the keywords 'vancomycin', 'intravenous', 'parenteral', 'continuous', 'intermittent', 'discontinuous', 'infusion', 'administration' and 'dosing'. Eleven studies were included in the meta-analysis. Neither heterogeneity nor publication bias were observed. Patients treated with CIV had a significantly lower incidence of nephrotoxicity compared with patients receiving IIV [risk ratio (RR)=0.61, 95% confidence interval (CI) 0.47-0.80; P<0.001]. No significant difference in treatment failure between the two groups was detected. Mortality between patients receiving CIV and patients receiving IIV was similar (RR=1.15, 95% CI 0.85-1.54; P=0.365). This meta-analysis showed that CIV had superior safety compared with IIV, whilst the clinical efficacy was not significantly different. A further multicentre, randomised controlled trial is required to confirm these results.
authors.affiliation: Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Hao
authors.affiliation: Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Surgical Intensive Care Unit, Fujian Provincial Clinical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China.
authors.forename: Han
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China. Electronic address: zhoujx.cn@icloud.com.
authors.forename: Jian-Xin
authors.initials: JX
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007674:Kidney Diseases / Q000139:chemically induced; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Clinical efficacy; Continuous infusion; Infection; Intermittent infusion; Safety; Vancomycin