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Int J Antimicrob Agents. 2011 Jan;37(1):75-7. doi: 10.1016/j.ijantimicag.2010.09.004. Epub 2010 Nov 11.

A higher dose of vancomycin in continuous infusion is needed in critically ill patients.

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Department of Microbiology, GZA St Vincentius Hospital, St Vincentiusstraat 20, 2018 Antwerp, Belgium.


Compared with intermittent infusion, continuous infusion of vancomycin is cheaper and logistically more convenient, achieves target concentrations faster, results in less variability in serum vancomycin concentrations, requires less therapeutic drug monitoring and causes less nephrotoxicity. Given that critically ill patients may develop very large volumes of distribution as well as supranormal drug clearance, in this study it was shown, despite the limited number of patients studied, that to achieve a target plateau concentration of 25mg/L a daily dose of 3000 mg of vancomycin in continuous infusion is needed following an appropriate loading dose.

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