Therapeutic drug monitoring of vancomycin in severe sepsis and septic shock

• DOI: 10.5414/cpp46140
• Publication Date: 2011-03-25T04:09:50Z
• Authors: M. Vázquez; P. Fagiolino; A. Boronat; M. Buroni; C. Maldonado
• Keywords: Therapeutic Drug Monitoring

The sudden changes (increase in capillary permeability, edema formation, vasodilation and hypotension) observed septic patients the measurements taken order to revert this situation make vancomycin concentrations difficult interpret. Therapeutic drug monitoring (TDM) of is routinely performed at steady state, target are peaks between 20 40 mg/l troughs 5-10 mg/l. Lately, continuous infusion (CIV) has been used as an alternative mode administration mainly critically ill with sepsis or shock. Despite novel administration, need population under discussion.The aim our study was test usefulness a multi-compartment model understand rapid that occur patients.A prospective, cohort carried out intensive care unit University Hospital. 25 adults severe shock receiving CIV modality for documented gram-positive infections were included study. Once started, blood samples drawn periodically analyzed by fluorescence polarisation immunoassay (FPIA, TDx, Abbott Laboratories, Chicago, IL, USA). A predict level evolution throughout treatment sepsis.High doses administered rescue from Plasma concentration dropped while clinical condition worsened. Conversely, levels increased spontaneously once infection reverted. theoretical provided greater insight into pharmacokinetic features related use patients.There consistency based prediction experimental data so dose adjustment reach above initial 3 grams per day recommended these levels.