Alvarez, RocioLopez Cortes, Luis EMolina, JoseCisneros, Jose MPachon, Jeronimo2023-01-252023-01-252016Álvarez R, López Cortés LE, Molina J, Cisneros JM, Pachón J. Optimizing the Clinical Use of Vancomycin. Antimicrob Agents Chemother. 2016 Apr 22;60(5):2601-9http://hdl.handle.net/10668/9819The 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.enBeta-lactam-resistant bacteriaVancomycin dosagePharmacokineticsSerum concentration monitoringNephrotoxicityRenal replacement therapyAnti-Bacterial AgentsDrug Administration ScheduleHumansMicrobial Sensitivity TestsStaphylococcus aureusVancomycinreview26856841Restricted AccessVancomicinaInfecciones por bacterias gram-positivasFarmacocinéticaNefrotoxicidadTerapia de reemplazo renalMonitorización de fármacos10.1128/AAC.03147-141098-6596PMC4862470https://europepmc.org/articles/pmc4862470?pdf=renderhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4862470/pdf