Is Trough Level Adequate for Determining Vancomycin Dosing in MRSA Bacteremia?

In a retrospective cohort study, the vancomycin trough level was not predictive of outcome, but the AUC/MIC was.

Most vancomycin dosing schemes for the treatment of serious methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) are designed to achieve a target area-under-the-curve/minimum-inhibitory-concentration ratio (AUC/MIC) ≥400. However, in clinical practice, a trough level (C_min) of 15–20 mg/L has been used as a surrogate.

In a manufacturer-funded retrospective cohort study involving 123 adults who received vancomycin while hospitalized with a MRSA BSI between January 2005 and June 2009, researchers evaluated the relationship between various vancomycin exposure variables and outcomes. The variables C_min and AUC were estimated for each patient using ADAPT 5, a pharmacokinetic/pharmacodynamic software program. With ADAPT,…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Is Trough Level Adequate for Determining Vancomycin Dosing in MRSA Bacteremia?

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Reviewing Author