Continuous intravenous administration of vancomycin in medical intensive care unit patients

J Crit Care. 2013 Feb;28(1):9-13. doi: 10.1016/j.jcrc.2012.02.003. Epub 2012 Mar 28.

Abstract

Purpose: The aim of this study was to evaluate continuous vancomycin infusion (contV) in intensive care unit patients.

Materials and 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.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / pharmacokinetics
  • Area Under Curve
  • Case-Control Studies
  • Drug Administration Schedule
  • Drug Monitoring
  • Female
  • Germany
  • Humans
  • Infusions, Intravenous
  • Intensive Care Units
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Retrospective Studies
  • Sepsis / drug therapy*
  • Vancomycin / administration & dosage*
  • Vancomycin / adverse effects
  • Vancomycin / pharmacokinetics

Substances

  • Anti-Bacterial Agents
  • Vancomycin