There is a significant amount of controversy regarding the most appropriate therapeutic goal for vancomycin therapy. The difference of opinion stems from the pharmacodynamic activity of vancomycin.
- MIC (minimum inhibitory concentration) – The minimum concentration of antibiotic to inhibit the growth of an organism.
- AUC (area under the curve) – The total exposure of an antibiotic to an organism Continue reading
Vancomycin is typically given as an intermittent infusion adjusted for body weight and renal function. Some clinicians believe that a continuous infusion of vancomycin may simplify therapy and make serum vancomycin levels more consistent.
Goal Vancomycin Level (Plateau)
Because continuous infusion vancomycin is a rare clinical occurrence, there is a lack of data regarding the optimal “plateau” level (serum drug level during continuous infusion therapy). Current evidence suggests that the vancomycin AUC:MIC ratio is the most important pharmacodynamic parameter associated with treatment success.1 Given that current guidelines recommend an AUC:MIC ratio of at least 400, a plateau of 20-25 mcg/mL (20 mcg/mL * 24 hrs) would provide an AUC:MIC ratio > 400 for isolates with an MIC of 1-1.5 mcg/mL. Continue reading