Executive Summary: Therapeutic Monitoring of Vancomycin for Serious Methicillin-Resistant Staphylococcus aureus Infections: A Revised Consensus Guideline and Review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists

被引：60

作者：

Rybak, Michael J. ^{[1
,2
,3
]}

Le, Jennifer ^{[4
]}

Lodise, Thomas P. ^{[5
,6
]}

Levine, Donald P. ^{[2
,3
]}

Bradley, John S. ^{[7
,8
]}

Liu, Catherine ^{[9
,10
]}

Mueller, Bruce A. ^{[11
]}

Pai, Manjunath P. ^{[11
]}

Wong-Beringer, Annie ^{[12
]}

Rotschafer, John C. ^{[13
]}

Rodvold, Keith A. ^{[14
]}

Maples, Holly D. ^{[15
,16
]}

Lomaestro, Benjamin M. ^{[6
]}

机构：

[1] Wayne State Univ, Dept Pharm Practice, Eugene Applebaum Coll Pharm & Hlth Sci, Antiinfect Res Lab, 259 Mack Ave, Detroit, MI 48201 USA

[2] Wayne State Univ, Sch Med, Detroit, MI USA

[3] Detroit Receiving Hosp & Univ Hlth Ctr, Detroit, MI USA

[4] Univ Calif San Diego, Skaggs Sch Pharm & Pharmaceut Sci, La Jolla, CA 92093 USA

[5] Albany Coll Pharm & Hlth Sci, Albany, NY USA

[6] Albany Med Ctr Hosp, Albany, NY 12208 USA

[7] Univ Calif San Diego, Dept Pediat, Div Infect Dis, La Jolla, CA 92093 USA

[8] Rady Childrens Hosp San Diego, San Diego, CA USA

[9] Univ Washington, Div Allergy & Infect Dis, Seattle, WA 98195 USA

[10] Fred Hutchinson Canc Res Ctr, Vaccine & Infect Dis Div, 1124 Columbia St, Seattle, WA 98104 USA

[11] Univ Michigan, Coll Pharm, 428 Church St, Ann Arbor, MI 48109 USA

[12] Univ Southern Calif, Sch Pharm, Los Angeles, CA 90007 USA

[13] Univ Minnesota, Coll Pharm, Minneapolis, MN 55455 USA

[14] Univ Illinois, Coll Pharm, Chicago, IL USA

[15] Univ Arkansas Med Sci, Coll Pharm, Little Rock, AR 72205 USA

[16] Univ Arkansas Med Sci, Arkansas Childrens Hosp, Little Rock, AR 72205 USA

来源：

PHARMACOTHERAPY | 2020年 / 40卷 / 04期

关键词：

vancomycin consensus guidelines; vancomycin; pharmacokinetics and pharmacodynamics; target attainment; nephrotoxicity;

D O I：

10.1002/phar.2376

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Background Recent vancomycin PK/PD and toxicodynamic studies enable a reassessment of the current dosing and monitoring guideline in an attempt to further optimize the efficacy and safety of vancomycin therapy. The area-under-the-curve to minimum inhibitory concentration (AUC/MIC) has been identified as the most appropriate pharmacokinetic/pharmacodynamic (PK/PD) target for vancomycin. The 2009 vancomycin consenus guidelines recommended specific trough concentrations as a surrogate marker for AUC/MIC. However, more recent toxicodynamic studies have reported an increase in nephrotoxicity associated with trough monitoring. Methods and Results This is the executive summary of the new vancomycin consensus guidelines for dosing and monitoring vancomycin therapy and was developed by the American Society of Health-Systems Pharmacists, Infectious Diseases Society of America, Pediatric Infectious Diseases Society and the Society of Infectious Diseases Pharmacists vancomycin consensus guidelines committee. Conclusions The recommendations provided in this document are intended to assist the clinician in optimizing vancomycin for the treatment of invasive MRSA infections in adult and pediatric patients. An AUC/MIC by broth microdilution (BMD) ratio of 400 to 600 (assuming MICBMD of 1 mg/L) should be advocated as the target to achieve clinical efficacy while improving patient safety for patients with serious MRSA infections. In such cases, AUC-guided dosing and monitoring is the most accurate and optimal way to manage vancomycin therapy.

引用

页码：363 / 367

页数：5