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Lancet. 1994 Dec 24-31;344(8939-8940):1748-50.

Why monitor peak vancomycin concentrations?

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Department of Infectious Diseases and Bacteriology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.


Peak and trough serum concentrations are routinely measured to monitor vancomycin therapy. Optimal therapy depends upon maintaining a concentration above that necessary for antibacterial activity and is therefore determined by the trough concentration. I determined the post dose increases in serum drug concentrations in routine clinical practice in adult patients without renal failure. Mean increases of 16.6 mg/L (SD 6.1) (peak samples collected 1 h post infusion) were measured from 165 paired samples. The results suggest that as long as trough concentrations do not exceed 15 mg/L, peak levels will not exceed normally accepted safe concentrations, and therefore do not need to be measured.

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