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Evaluation of a dosing regimen for continuous vancomycin infusion in critically ill patients: an observational study in intensive care unit patients.

Abstract：

PURPOSE:We aimed to evaluate a dosing algorithm for continuous vancomycin administration in intensive care unit patients. MATERIALS AND METHODS:This observational study was conducted in a medical intensive care unit (German university hospital; June 2012-February 2013). Following a loading dose of 20 mg per kg actual body weight, vancomycin was administered continuously (20 or 30 mg of vancomycin per kg actual body weight over 24 hours depending on renal function). The vancomycin infusion rate was adjusted to achieve a target serum vancomycin concentration of 20-30 mg/L. RESULTS:Vancomycin was administered for a median (interquartile range) of 7 (5-9) days. The median vancomycin dose given as an initial bolus was 1750 (1400-2000) mg. The median daily vancomycin dose ranged from 480 (180-960) mg (day 6) to 3.120 (2596-3980) mg (day 1). Altogether, the achieved median serum vancomycin concentration was 29.0 (25.2-33.2) mg/L. On treatment days 1 to 7, we observed target serum vancomycin levels (20-30 mg/L) in 48%, 39%, 33%, 26%, 43%, 57%, and 69% of patients. Supra-therapeutic serum vancomycin concentrations (>30 mg/L) were observed in 36%, 52%, 61%, 63%, 39%, 19%, and 15% of patients on treatment days 1 to 7. CONCLUSIONS:The evaluated vancomycin dosing regimen for continuous infusion allowed rapid achievement of sufficient vancomycin serum levels. However, we frequently observed supra-therapeutic serum vancomycin concentrations in the first days of vancomycin treatment.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Saugel B,Gramm C,Wagner JY,Messer M,Lahmer T,Meidert AS,Schmid RM,Huber W

doi

10.1016/j.jcrc.2013.12.007

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

351-5

issue

3

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(13)00475-9

journal_volume

29

pub_type

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