Level of evidence for therapeutic drug monitoring of vancomycin

Vancomycin is an antibiotic for exclusive hospital use administrated in intravenous infusion to treat systemic infections. It is mainly eliminated by kidneys and potentially nephrotoxic. Data available show that Therapeutic Drug Monitoring (TDM) of vancomycin is highly recommended. It aims to ensure...

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Veröffentlicht in:Therapie 2011-01, Vol.66 (1), p.29
Hauptverfasser: Jelassi, Mohamed Larbi, Benlmouden, Amine, Lefeuvre, Sandrine, Mainardi, Jean-Luc, Billaud, Eliane M
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creator Jelassi, Mohamed Larbi
Benlmouden, Amine
Lefeuvre, Sandrine
Mainardi, Jean-Luc
Billaud, Eliane M
description Vancomycin is an antibiotic for exclusive hospital use administrated in intravenous infusion to treat systemic infections. It is mainly eliminated by kidneys and potentially nephrotoxic. Data available show that Therapeutic Drug Monitoring (TDM) of vancomycin is highly recommended. It aims to ensure efficacy and avoid resistance by maintaining trough plasma concentrations above the MIC. Secondary, vancomycine TDM may be indicated to prevent nephrotoxicity in high risk patients. TDM is often underwent at steady state (48 to 72 h after the treatment initiation) unless in case of renal impairment (24 h). While compared with intermittent administration, continuous infusion did not result in prognosis improvement; however it resulted in lower pharmacokinetic variability and better cost-efficiency. Targeted trough concentrations for intermittent infusion are between 15 and 20 mg/L (up to 25-30 mg/L for GISA). In case of continuous infusion, targets are higher (25 to 40 mg/L).
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subjects Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - economics
Anti-Bacterial Agents - pharmacokinetics
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy
Bacterial Infections - economics
Bacterial Infections - microbiology
Dose-Response Relationship, Drug
Drug Monitoring - methods
Evidence-Based Medicine
Humans
Infusions, Intravenous
Kidney Diseases - complications
Kidney Diseases - metabolism
Vancomycin - administration & dosage
Vancomycin - adverse effects
Vancomycin - economics
Vancomycin - pharmacokinetics
Vancomycin - therapeutic use
title Level of evidence for therapeutic drug monitoring of vancomycin
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