Effect of Vancomycin Administration Method on Achieving and Maintaining Its Serum Concentrations In Intensive Care Patients

Introduction. Vancomycin may be administered by bolus injections (BI) and continuous infusion (CI). Data on BI and CI clinical effectiveness and correlation with mortality, survival and renal injury is variable.

Aim of the study. The aim of the study was to compare the use of vancomycin continuous infusion and bolus administration in intensive care.

Materials and methods. Retrospective analysis of 46 ICU patients (23 patients received vancomycin CI and 23 - BI) was undertaken to compare efficacy and effect on mortality and morbidity of these two administration methods.

Results. The study revealed association of CI administration with more effective (15 - 25 mg/L) serum vancomycin trough concentration maintenance (31.2% vs 25.6% of treatment time, p=0.011) as well as with reduced incidence of subtherapeutic vancomycin levels (34.3% vs 37.2% of treatment time, p=0.015). We also observed better survival times using CI mode.

Conclusions. CI appears to be beneficial in terms of better maintenance of target VSTC and better patient survival. However, its use compared to bolus administration has no statistically significant impact on overall mortality and incidence of nephrotoxicity.