Vancomycin dosing for pneumonia in critically ill trauma patients

Asad E Patanwala, Christopher J. Norris, David E. Nix, Brian J. Kopp, Brian L Erstad

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Vancomycin has been recommended as the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia with a desired trough concentration of 15 to 20 mg/L. The purpose of this study was to evaluate the initial dosing of vancomycin for MRSA pneumonia in critically ill adult trauma patients. Methods: Critically ill adult trauma patients were retrospectively identified for inclusion into the study. Patients initiated at a dose of 1 g intravenously (i.v.) every 8 hours were compared with patients initiated at a dose of 1 g i.v. every 12 hours. Baseline continuous demographic variables and steady-state vancomycin trough concentrations were compared between the two groups using a Student's t test (α = 0.05). Results: There were 36 patients who satisfied criteria for inclusion, 17 patients in the 1 g every 8 hour group and 19 patients in the 1 g every 12 hour group. The mean steady-state trough concentration was higher in the 1 g every 8 hour group versus the 1 g every 12 hour group (11.1 vs. 6.8 mg/L, p = 0.014). A steady-state trough concentration greater than 15 mg/L was achieved in 23.5% of the patients in the 1 g every 8 hour group and none of the patients in the 1 g every 12 hour group. Conclusion: A vancomycin regimen of 1 g i.v. every 12 hours in critically ill trauma patients with MRSA pneumonia and normal renal function is unlikely to achieve trough concentrations of 15 to 20 mg/L. Doses of at least 1 g i.v. every 8 hours are needed. coypright

Original languageEnglish (US)
Pages (from-to)802-804
Number of pages3
JournalJournal of Trauma
Volume67
Issue number4
DOIs
StatePublished - Oct 2009

Fingerprint

Vancomycin
Critical Illness
Pneumonia
Wounds and Injuries
Staphylococcal Pneumonia
Methicillin-Resistant Staphylococcus aureus
Demography
Students
Kidney

Keywords

  • Kinetics
  • Pneumonia
  • Trauma
  • Vancomycin

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Vancomycin dosing for pneumonia in critically ill trauma patients. / Patanwala, Asad E; Norris, Christopher J.; Nix, David E.; Kopp, Brian J.; Erstad, Brian L.

In: Journal of Trauma, Vol. 67, No. 4, 10.2009, p. 802-804.

Research output: Contribution to journalArticle

Patanwala, Asad E ; Norris, Christopher J. ; Nix, David E. ; Kopp, Brian J. ; Erstad, Brian L. / Vancomycin dosing for pneumonia in critically ill trauma patients. In: Journal of Trauma. 2009 ; Vol. 67, No. 4. pp. 802-804.
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abstract = "Background: Vancomycin has been recommended as the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia with a desired trough concentration of 15 to 20 mg/L. The purpose of this study was to evaluate the initial dosing of vancomycin for MRSA pneumonia in critically ill adult trauma patients. Methods: Critically ill adult trauma patients were retrospectively identified for inclusion into the study. Patients initiated at a dose of 1 g intravenously (i.v.) every 8 hours were compared with patients initiated at a dose of 1 g i.v. every 12 hours. Baseline continuous demographic variables and steady-state vancomycin trough concentrations were compared between the two groups using a Student's t test (α = 0.05). Results: There were 36 patients who satisfied criteria for inclusion, 17 patients in the 1 g every 8 hour group and 19 patients in the 1 g every 12 hour group. The mean steady-state trough concentration was higher in the 1 g every 8 hour group versus the 1 g every 12 hour group (11.1 vs. 6.8 mg/L, p = 0.014). A steady-state trough concentration greater than 15 mg/L was achieved in 23.5{\%} of the patients in the 1 g every 8 hour group and none of the patients in the 1 g every 12 hour group. Conclusion: A vancomycin regimen of 1 g i.v. every 12 hours in critically ill trauma patients with MRSA pneumonia and normal renal function is unlikely to achieve trough concentrations of 15 to 20 mg/L. Doses of at least 1 g i.v. every 8 hours are needed. coypright",
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