Continuous versus Intermittent Infusion of Vancomycin in Severe Staphylococcal Infections: Prospective Multicenter Randomized Study

摘要: A continuous infusion of vancomycin (CIV) may provide an alternative mode in severe hospital-acquired methicillin-resistant staphylococcal (MRS) infections. multicenter, prospective, randomized study was designed to compare CIV (targeted plateau drug serum concentrations 20 25 mg/liter) and intermittent infusions (IIV; targeted trough 10 15 119 critically ill patients with MRS infections (bacteremic infections, 35%; pneumonia, 45%). Microbiological clinical outcomes, safety, pharmacokinetics, ease treatment adjustment, cost were compared. outcomes safety similar. reached the faster (36 +/- 31 versus 51 39 h, P = 0.029) fewer samples required for monitoring than IIV (7.7 2.2 11.8 3.9 per treatment, < 0.0001). The variability between both area under concentration-time curve (AUC(24h)) daily dose given over days lower (variances, 14,621 53,975 mg(2)/liter(2)/h(2) [P 0.026] 414 818 g(2) 0.057], respectively). 10-day patient $454 137 group 23% ($321 81: In summary, comparable efficacy tolerance, be a cost-effective IIV.