Comparison of intermittent versus continuous-infusion vancomycin for treating severe patients in intensive care units

Abstract

PurposeThe aim of this study was to compare pharmacokinetic characteristics between intermittent infusion and continuous infusion of vancomycin for critically ill patients admitted to intensive care units. MethodsIntermittent therapy was administered for 60minutes and prescribed as a loading dose of 30mg/kg and continued with 15mg/kg q12h. Continuous infusion was prescribed as a loading dose of 30mg/kg followed by 30mg/kg on constant infusion pump. Blood samples from vancomycin intermittent infusion group were collected 1h before third dose, 1h, 8h and 24h after third dose infusion. Blood samples from vancomycin continuous infusion group were collected 1h after loading dose, 12h, 24h, 36h, and 48h after continuous infusion initiation. ResultsMedian serum concentration of continuous infusion group at 24-hour was 23.59μg/mL [14.52–28.97], while of intermittent infusion group at 23-hour was 12.30μg/mL [7.27–18.12] and on 25-hour was 17.58μg/mL [12.5–22.5]. Medians AUC24–48h were 357.2mg.h/L and 530.2mg.h/L for intermittent infusion and continuous infusion groups, respectively (p=0.559). ConclusionVancomycin CI reached steady state earlier, which guaranteed therapeutic levels from the first day and made it possible to manage therapeutic drug monitoring faster.