Therapeutic Monitoring of Vancomycin for Serious Methicillin-resistant Staphylococcus aureus Infections: A Revised Consensus Guideline and Review by the American Society of Health-system Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists

Author:

Rybak Michael J123,Le Jennifer4,Lodise Thomas P5,Levine Donald P23,Bradley John S67,Liu Catherine89,Mueller Bruce A10,Pai Manjunath P10,Wong-Beringer Annie11,Rotschafer John C12,Rodvold Keith A13,Maples Holly D14,Lomaestro Benjamin15

Affiliation:

1. Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA

2. School of Medicine, Wayne State University, Detroit, Michigan, USA

3. Detroit Receiving Hospital, Detroit, Michigan, USA

4. Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA

5. Albany College of Pharmacy and Health Sciences, Albany, New York, USA

6. Department of Pediatrics, Division of Infectious Diseases, University of California, San Diego, La Jolla, California, USA

7. Rady Children’s Hospital San Diego, San Diego, California, USA

8. Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA

9. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA

10. University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA

11. University of Southern California School of Pharmacy, Los Angeles, California, USA

12. University of Minnesota College of Pharmacy, Minneapolis, Minnesota, USA

13. University of Illinois College of Pharmacy, Chicago, Illinois, USA

14. University of Arkansas for Medical Sciences College of Pharmacy and Arkansas Children’s Hospital, Little Rock, Arkansas, USA

15. Albany Medical Center Hospital, Albany, New York, USA

Abstract

Abstract Recent clinical data on vancomycin pharmacokinetics and pharmacodynamics suggest a reevaluation of current dosing and monitoring recommendations. The previous 2009 vancomycin consensus guidelines recommend trough monitoring as a surrogate marker for the target area under the curve over 24 hours to minimum inhibitory concentration (AUC/MIC). However, recent data suggest that trough monitoring is associated with higher nephrotoxicity. This document is an executive summary of the new vancomycin consensus guidelines for vancomycin dosing and monitoring. It was developed by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists vancomycin consensus guidelines committee. These consensus guidelines recommend an AUC/MIC ratio of 400–600 mg*hour/L (assuming a broth microdilution MIC of 1 mg/L) to achieve clinical efficacy and ensure safety for patients being treated for serious methicillin-resistant Staphylococcus aureus infections.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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