Vancomycin why monitor serum levels

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Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Reprints or correspondence: Dr. Wolfe Street, Baltimore, Maryland Oxford Academic. Google Scholar. Nancy A.

Paul S. Revision received:. Cite Cite Thomas G. Select Format Select format. Permissions Icon Permissions. Abstract Although monitoring serum vancomycin concentrations in clinical practice is commonplace, the data supporting this practice are meager. Issue Section:.

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Please check for further notifications by email. Vancomycin is also used when patients are intolerant or allergic to beta-lactam antibiotics. Vancomycin has been associated with nephrotoxicity and ototoxicity, although it appears that many of these reports reflected impurities in early formulations.

Monitoring of vancomycin-related nephrotoxicity is recommended only for patients with reduced renal function, those receiving aggressive or prolonged vancomycin regimens, or those at high-risk including patients comedicated with other nephrotoxic agents. Trough concentrations are recommended for therapeutic monitoring of vancomycin, preferably acquired at steady-state just before fourth dose.

To avoid development of resistance, vancomycin trough levels should remain above Complicated infections require higher target levels, typically Peak concentrations do not correlate well to efficacy or nephrotoxicity, but may be useful for pharmacokinetic analyses eg, area under the curve: AUC studies or for select patients. Trough levels correlate better with efficacy than peak levels, with target trough levels of As with any assay employing mouse antibodies, the possibility exists for interference by human antimouse antibodies HAMA in the sample, which could cause falsely lowered results.

Am J Health Syst Pharm. Mayo Clinic.