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Current guidelines advise against extended vancomycin infusion through midline catheters, because of concerns about its tissue damaging properties and heightened risk for thrombophlebitis. Despite these concerns, vancomycin still is prescribed commonly via midline catheter for outpatient parenteral antimicrobial therapy (OPAT) for many patients who are discharged with methicillin-resistant Staphylococcus aureus infections.
Researchers from the Michigan Hospital Medicine Safety Consortium evaluated midline catheter complications in recently discharged patients who received either vancomycin or nonvancomycin antimicrobials as OPAT (600 and 2700 patients, respectively). During 30 days of follow-up, vancomycin was associated with significantly h…