Switching From Intermittent to Continuous Infusion of Vancomycin in Critically Ill Patients: Toward a More Robust Exposure

Therapeutic Drug Monitoring
Erik M van MaarseveenArthur R H van Zanten

Abstract

To increase target attainment rates, switching the mode of administration from intermittent (InI) to continuous infusion (CoI) has been proposed. In this study, target attainment rates and interpatient variation in exposure were compared between vancomycin InI- and CoI-treated critically ill patients. An observational cohort study was conducted among critically ill patients admitted to a level-2 intensive care unit. Adult patients (18 years or older) treated with intravenous vancomycin for various indications, including sepsis, pneumonia, and endocarditis between 2007 and 2013 were eligible for inclusion. In 2010, vancomycin mode of administration switched from intermittent to continuous. Vancomycin was administered through intravenous infusion, and dosing was guided by therapeutic drug monitoring. Target attainment rates and variations in serum concentration and estimated area under the curve (AUC) were compared between groups. The target attainment rate for therapeutic vancomycin exposure was higher in the group treated with CoI than in patients treated with InI (48% versus 19%, P < 0.001). Furthermore, between-patient variation in vancomycin serum concentration was nearly twice as high in intermittently infused patients comp...Continue Reading

References

Jul 16, 2008·International Journal of Antimicrobial Agents·Francesco Scaglione, Luca Paraboni
Feb 25, 2009·Critical Care Medicine·Jason A Roberts, Jeffrey Lipman
Oct 30, 2013·Antimicrobial Agents and Chemotherapy·Michael N NeelyThomas P Lodise
Aug 30, 2014·European Journal of Clinical Pharmacology·Erik M van MaarseveenArthur R H van Zanten

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Citations

Nov 1, 2017·Antimicrobial Agents and Chemotherapy·Evan J ZasowskiMichael J Rybak
Sep 13, 2017·Antimicrobial Agents and Chemotherapy·Susanna Edith Medellín-GaribayEmilia Barcia
Mar 19, 2020·Experimental Biology and Medicine·Renato de L VitorassoHenrique T Moriya
May 21, 2020·Therapeutic Drug Monitoring·Erik M van MaarseveenArthur R H van Zanten

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