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Desired Vancomycin Trough Serum Concentration for Treating Invasive Methicillin-resistant Staphylococcal Infections

Frymoyer, Adam MD*; Guglielmo, B. Joseph PharmD; Hersh, Adam L. MD, PhD

The Pediatric Infectious Disease Journal: October 2013 - Volume 32 - Issue 10 - p 1077–1079
doi: 10.1097/INF.0b013e318299f75c
Antimicrobial Reviews

Vancomycin area under the curve/minimal inhibitory concentration (AUC/MIC) >400 best predicts the outcome when treating invasive methicillin-resistant Staphylococcus aureus infection; however, trough serum concentrations are used clinically to assess the appropriateness of dosing. We used pharmacokinetic modeling and simulation to examine the relationship between vancomycin trough values and AUC/MIC in children receiving vancomycin 15 mg/kg every 6 hours and methicillin-resistant Staphylococcus aureus MIC of 1 μg/mL. A trough of 7–10 μg/mL predicted achievement of AUC/MIC >400 in >90% of children.

From the *Department of Pediatrics, Stanford University, Palo Alto, CA; Department of Clinical Pharmacy, University of California San Francisco, CA; and Department of Pediatrics, University of Utah, Salt Lake City, UT.

Accepted for publication March 31, 2013.

The authors have no funding or conflicts of interest to disclose.

Accepted as an abstract for presentation at the 2013 Pediatric Academic Societies’ Annual Meeting, May 4–7, 2013; Washington, DC.

Address for correspondence: Adam Frymoyer, MD, Department of Pediatrics, Stanford University, 750 Welch Rd, Suite 315, Palo Alto, CA 94304. E-mail:

© 2013 by Lippincott Williams & Wilkins, Inc.