Publication:
Optimizing the Clinical Use of Vancomycin.

dc.contributor.authorAlvarez, Rocio
dc.contributor.authorLopez Cortes, Luis E
dc.contributor.authorMolina, Jose
dc.contributor.authorCisneros, Jose M
dc.contributor.authorPachon, Jeronimo
dc.contributor.funderPlan Nacional de I+D+i and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía y Competitividad, Spanish Network for Research in Infectious Diseases
dc.date.accessioned2023-01-25T08:30:54Z
dc.date.available2023-01-25T08:30:54Z
dc.date.issued2016
dc.description.abstractThe increasing number of infections produced by beta-lactam-resistant Gram-positive bacteria and the morbidity secondary to these infections make it necessary to optimize the use of vancomycin. In 2009, the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Disease Pharmacists published specific guidelines about vancomycin dosage and monitoring. However, these guidelines have not been updated in the past 6 years. This review analyzes the new available information about vancomycin published in recent years regarding pharmacokinetics and pharmacodynamics, serum concentration monitoring, and optimal vancomycin dosing in special situations (obese people, burn patients, renal replacement therapy, among others). Vancomycin efficacy is linked to a correct dosage which should aim to reach an area under the curve (AUC)/MIC ratio of ≥400; serum trough levels of 15 to 20 mg/liter are considered a surrogate marker of an AUC/MIC ratio of ≥400 for a MIC of ≤1 mg/liter. For Staphylococcus aureus strains presenting with a MIC >1 mg/liter, an alternative agent should be considered. Vancomycin doses must be adjusted according to body weight and the plasma trough levels of the drug. Nephrotoxicity has been associated with target vancomycin trough levels above 15 mg/liter. Continuous infusion is an option, especially for patients at high risk of renal impairment or unstable vancomycin clearance. In such cases, vancomycin plasma steady-state level and creatinine monitoring are strongly indicated.
dc.description.versionNo
dc.identifier.citationÁlvarez R, López Cortés LE, Molina J, Cisneros JM, Pachón J. Optimizing the Clinical Use of Vancomycin. Antimicrob Agents Chemother. 2016 Apr 22;60(5):2601-9
dc.identifier.doi10.1128/AAC.03147-14
dc.identifier.essn1098-6596
dc.identifier.pmcPMC4862470
dc.identifier.pmid26856841
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4862470/pdf
dc.identifier.unpaywallURLhttps://europepmc.org/articles/pmc4862470?pdf=render
dc.identifier.urihttp://hdl.handle.net/10668/9819
dc.issue.number5
dc.journal.titleAntimicrobial agents and chemotherapy
dc.journal.titleabbreviationAntimicrob Agents Chemother
dc.language.isoen
dc.organizationInstituto de Biomedicina de Sevilla-IBIS
dc.organizationHospital Universitario Virgen del Rocío
dc.organizationHospital Universitario Virgen Macarena
dc.page.number2601-2609
dc.provenanceRealizada la curación de contenido 24/06/2025.
dc.publisherAmerican Society for Microbiology
dc.pubmedtypeJournal Article
dc.pubmedtypeReview
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.relation.projectIDREIPI RD12/0015/0001
dc.relation.publisherversionhttps://journals.asm.org/doi/10.1128/AAC.03147-14?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
dc.rights.accessRightsRestricted Access
dc.subjectBeta-lactam-resistant bacteria
dc.subjectVancomycin dosage
dc.subjectPharmacokinetics
dc.subjectSerum concentration monitoring
dc.subjectNephrotoxicity
dc.subjectRenal replacement therapy
dc.subject.decsVancomicina
dc.subject.decsInfecciones por bacterias gram-positivas
dc.subject.decsFarmacocinética
dc.subject.decsNefrotoxicidad
dc.subject.decsTerapia de reemplazo renal
dc.subject.decsMonitorización de fármacos
dc.subject.meshAnti-Bacterial Agents
dc.subject.meshDrug Administration Schedule
dc.subject.meshHumans
dc.subject.meshMicrobial Sensitivity Tests
dc.subject.meshStaphylococcus aureus
dc.subject.meshVancomycin
dc.titleOptimizing the Clinical Use of Vancomycin.
dc.typereview
dc.type.hasVersionVoR
dc.volume.number60
dspace.entity.typePublication

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