Current view of vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections
Abstract
The review article interprets recommendations for treating methicillin-resistant Staphylococcus aureus (MRSA) infections with vancomycin. These stem from a 2009 consensus followed by numerous preclinical and clinical studies carried out until now.
They are based on defining the predictors of the bactericidal activity of vancomycin that are different from those in beta-lactam and aminoglykoside antibiotics. The predictors are AUC0-24/MIC>400 and Cmin.
Practice requires recommendations on how to achieve maximuml effiectiveness and safety of vancomycin administered by intermittent versus continuous infusion by attaining target concentrations under dynamically changing conditions. Changes in the kinetics and dynamics of antibiotics due to pathological covariates (SIRS, sepsis) and treatment should be detected as soon as possible therapeutic monitoring aimed at individual adjustment of dosage.