Journal
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
Volume 39, Issue 5, Pages 420-423Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.ijantimicag.2011.12.011
Keywords
Creatinine clearance; Vancomycin; Continuous infusion; Therapeutic drug monitoring; Sepsis
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The aim of this study was to evaluate the effect of augmented renal clearance (ARC) on vancomycin serum concentrations in critically ill patients. This prospective, single-centre, observational, cohort study included 93 consecutive, critically ill septic patients who started treatment that included vancomycin by continuous infusion, admitted over a 2-year period (March 2006 to February 2008). ARC was defined as 24-h creatinine clearance (CLCr) > 130 mL/min/1.73 m(2). Two groups were analysed: Group A, 56 patients with a CLCr <= 130 mL/min/1.73 m(2); and Group B, 37 patients with a CLCr > 130 mL/min/1.73 m(2). Vancomycin therapeutic levels were assessed on the first 3 days of treatment (D-1, D-2 and D-3). Serum vancomycin levels on D-1, D-2 and D-3, respectively, were 13.1, 16.6 and 18.6 mu mol/L for Group A and 9.7, 11.7 and 13.8 mu mol/L for Group B (P < 0.05 per day). The correlation between CLCr and serum vancomycin on D-1 was -0.57 (P < 0.001). ARC was strongly associated with subtherapeutic vancomycin serum concentrations on the first 3 days of treatment. (C) 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
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