CONTINUOUS-INFUSION OF VANCOMYCIN IN CRIT ICALLY ILL PATIENTS - A NEWTREND

Vancomycin, is clearly the choice drug to treat methicillin-resistant staphylococci infections, but slow response and therapeutic failure ha ve been reported. The efficacy of vancomycin is not in proportion to t he post-infusion concentration but to the lenght of time for which van comycin concentration at the infection site is high enough to inhibit the pathogen. Continuous infusion may be a better way of maximizing th at time and thus, vancomycin efficacy. Continuous infusion of vancomyc in has been used in various situations but the efficacy and tolerance of continuous infusion have never been compared with those of conventi onal discontinuous infusion. Recent pharmacokinetic studies and a case -control study suggested that the efficacy of vancomycin may be improv ed through continuous infusion. More recently, we carried out a prospe ctive multicenter study to compare continuous and discontinuous infusi on of vancomycin, demonstrating that for a comparable efficacy and tox icity, continuous infusion was easier to adjust and more cost-efficien t.