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.
Keywords
VancomycinMedicinePediatric Infectious DiseaseDosingGuidelineTherapeutic drug monitoringIntensive care medicineMethicillin-resistant Staphylococcus aureusBroth microdilutionStaphylococcus aureusMinimum inhibitory concentrationPharmacokineticsAntibioticsInternal medicineMicrobiologyPathology
Affiliated Institutions
- Eugene Applebaum College of Pharmacy and Health Sciences US
- University of Minnesota US
- Fred Hutch Cancer Center US
- University of Illinois Chicago US
- Albany Medical Center Hospital US
- Detroit Receiving Hospital US
- University of California, San Diego US
- University of Michigan US
- University of Arkansas for Medical Sciences US
- Albany Stratton VA Medical Center Albany US
- Albany College of Pharmacy and Health Sciences US
- University of Southern California US
- University of Washington US
- Rady Children's Hospital-San Diego US
- Wayne State University US
- Cancer Research Center US
- Illinois College US
- Arkansas Children's Hospital US
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Publication Info
- Year
- 2020
- Type
- article
- Volume
- 77
- Issue
- 11
- Pages
- 835-864
- Citations
- 1004
- Access
- Closed
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Cite This
Michael J. Rybak,
Jennifer Lê,
Thomas P. Lodise
et al.
(2020).
Therapeutic monitoring of vancomycin for serious methicillin-resistant <i>Staphylococcus aureus</i> 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.
American Journal of Health-System Pharmacy
, 77
(11)
, 835-864.
https://doi.org/10.1093/ajhp/zxaa036
Identifiers
- DOI
- 10.1093/ajhp/zxaa036