Monitoring of vancomycin serum levels for the treatment of staphylococcal infections

ABSTRACTVancomycin serum concentrations were determined for 1737 patients treated with either 2 × 1 g of vancomycin or 4 × 500 mg daily (780 patients), according to current nomograms, or by continuous infusion (957 patients) with a loading dose (1 g) and a total of 2–6 g daily. Trough serum concentrations were determined after 36–48 h. Adequate serum levels for the treatment of a normal methicillin-resistant Staphylococcus aureus (MRSA) and a glycopeptide-intermediate S. aureus (GISA) were observed in 81% and 20.9% of patients, respectively. The data support theoretical arguments that higher and more sustained serum levels of vancomycin, obtained by continuous infusion, may enhance clinical efficacy.