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

• Published in: Clinical infectious diseases Vol. 71; no. 6; pp. 1361 - 1364
• Main Authors: Rybak, Michael J, Le, Jennifer, Lodise, Thomas P, Levine, Donald P, Bradley, John S, Liu, Catherine, Mueller, Bruce A, Pai, Manjunath P, Wong-Beringer, Annie, Rotschafer, John C, Rodvold, Keith A, Maples, Holly D, Lomaestro, Benjamin
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 12.09.2020
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Area Under Curve; Child; Communicable Diseases - drug therapy; Humans; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Pharmacists; Staphylococcal Infections - drug therapy; United States; Vancomycin - pharmacology; Vancomycin - therapeutic use; United States; vancomycin consensus guidelines; vancomycin; nephrotoxicity; target attainment; pharmacokinetics and pharmacodynamics
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/ciaa303

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.