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Although weight-based dosing of vancomycin is advocated by several consensus guidelines, a flat-dosing regimen of 1 g every 12 hours has been used in many clinical studies. With the recognition that Staphylococcus aureus is heterogeneously resistant to vancomycin, achieving adequate serum levels of the drug is now critical. To assess vancomycin dosing in the clinical setting, researchers conducted a retrospective review at two tertiary care medical centers in Texas. Patients were divided into cohorts according to their body-mass index (BMI): underweight (<18.5), normal weight (18.5–24.9), overweight (25.0–29.9), or obese (≥30.0).
In a random sample of 421 adults who had received vancomycin between July 2003 and June 2006, 100% of underweight…