Effectiveness and Safety of Continuous Intravenous Infusion of Vancomycin in Non-Critically Ill Patients
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Abstract
Vancomycin is an antibiotic commonly used to treat infections caused by Gram-positive bacteria. Recent guideline has suggested to administer the drug as continuous intravenous in critically ill patients. However, there are no specific recommendations for its use in non-critically ill patients. Objective: To study the use pattern of continuous intravenous vancomycin infusion and its clinical outcomes in non-critically ill patients. Methods: A retrospective descriptive analysis was conducted on patients receiving continuous intravenous vancomycin at Srinagarind Hospital between January 1, 2010, and October 31, 2023. Effectiveness was measured by early clinical response, end-of-treatment outcomes, target attainment, and 30-day all-cause mortality. Safety outcomes were assessed using the incidence of vancomycin-induced nephrotoxicity. The relationship between vancomycin dose and the plasma drug concentration was assessed using Pearson correlation. Results: A total of 15 patients were included in the study. The most common infections in patients were bacteremia (33%) and central nervous system infections (20%). Three patients (20%) achieved the target attainment, with a mean dose of 55.5 ± 3.1 mg/kg/day. The improvement was found in 9 patients (60%) in early clinical response and 11 patients (73%) by the end of treatment. No patients experienced 30-day all-cause mortality or nephrotoxicity. A moderately positive correlation between vancomycin dose and the drug concentration was observed, with statistical significance (r2 = 0.523, p-value < 0.05). Conclusion: Continuous intravenous vancomycin appears to be an effective and safe treatment option for non-critically ill patients, with no evidence of nephrotoxicity in this study.
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