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Ann Fr Anesth Reanim. 2010 Jan;29(1):55-7. doi: 10.1016/j.annfar.2009.12.002. Epub 2010 Jan 13.

[Dosage adjustment of vancomycin in continuous infusion in critically ill-patients].

[Article in French]

Author information

1
Laboratoire de bactériologie-virologie, CHU de Saint-Etienne, avenue A.-Raimond, 42277 Saint-Priest-en-Jarez, France.

Abstract

INTRODUCTION:

As the susceptibility of staphylococcal strains to glycopeptides rises, it is becoming necessary to increase vancomycin dosages.

OBJECTIVE:

To evaluate an administration protocol for vancomycin using continuous infusion with a loading dose of 30 mg/kg followed by 30 mg/kg per 24h in intensive care patients presenting creatinine clearance (CLc) greater than 50.

RESULTS:

A total of 22 patients were included in the study. Serum vancomycin concentrations after 24h (C24h) ranged from 25 to 30 mg/l in seven of 14 patients with CLc less than 120 ml/min (50 %), compared with three patients (21 %) with C24h greater than 35 mg/l and four patients (29 %) with C24 h less than 25 mg/l. However, C24h was less than 20mg/l for the eight patients with CLc greater or equal to 120 ml/min. Bacteriological data was available for eight of the 14 patients with CLc less than 120 ml/min, and in these eight patients, the C24h/MIC was greater or equal to 8; seven of these patients had an AUC/MIC greater or equal to 350.

CONCLUSION:

Assay of serum vancomycin concentrations after 24h of treatment is necessary to enable rapid adjustment of vancomycin concentration in order to improve therapeutic efficacy or avoid nephrotoxicity.

PMID:
20074899
DOI:
10.1016/j.annfar.2009.12.002
[Indexed for MEDLINE]

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