Evaluation of vancomycin serum trough concentrations and outcomes in meticillin-resistant Staphylococcus aureus bacteraemia

Vancomycin Trough Concentration as a Predictor of Clinical Outcomes in Patients withStaphylococcus aureusBacteremia: A Meta-analysis of Observational Studies

“…Of 377 studies retrieved from the PubMed query and two studies retrieved from bibliographic review, only 14 studies ultimately met the criteria to be incorporated into the final analyses (Figure ) . These studies were published from 2011 to 2014, with 1677 unique patients representing geriatric and unspecified inpatients (Table ) . Treatment failure was an outcome of seven studies, all of which used a definition of treatment failure that included mortality and persistent bacteremia .…”

“…8,[13][14][15][16][17][18][19][20][21][22][23][24][25] These studies were published from 2011 to 2014, with 1677 unique patients representing geriatric 19 and unspecified inpatients ( Table 1). 8,[13][14][15][16][17][18][20][21][22][23][24][25] Treatment failure was an outcome of seven studies, all of which used a definition of treatment failure that included mortality and persistent bacteremia. 8, 14, 16-18, 22, 23 Trough concentration was reported as a dichotomous variable in eight studies and a continuous variable in eight studies, with two studies reporting both continuous and dichotomous variables.…”

“…One limitation of this analysis was that the secondary analyses focused on components of a validated definition of treatment failure while excluding the component of recurrent bacteremia . Although this outcome was reported in several studies included in the analysis, the outcome itself is limited by several factors: it does not appear to be associated with MRSA bacteremia–associated mortality, and the potential exists for misinterpreting recurrent infections as new infections or new infections as recurrent infections . These factors make the bacterial recurrence outcome less clinically relevant and easily measurable as the other components of the common definition of treatment failure (mortality and persistent bacteremia), which were considered in the secondary analyses.…”

Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis

“…Four of the studies were prospective cohort studies [11,[32][33][34] and 12 were retrospective cohort studies [35][36][37][38][39][40][41][42][43][44] CMI years. The average trough value over the duration of therapy was examined in four studies [11,32,36,38] and the initial trough value in 13 studies [11,34,35,37 -40,43-46] [38,39] and 4 studies reported AUC or AUC/MIC ratio [32,33,35,46]. Albur et al [38] reported a mean MIC level of 0.72 ± 0.12 mg/L, and Arshad et al [39] reported a mean MIC level of 0.53 ± 0.23 mg/L.…”

Vancomycin serum trough concentration vs. clinical outcome in patients with gram-positive infection: a retrospective analysis

“…Jeffres reported that the trough concentration was not significantly different between survivors and no‐survivors among patients with healthcare‐associated pneumonia. Arshad also found that the clinical failure rate when vancomycin trough concentration was lower than 15 mg/L was not significantly different compared to that when vancomycin trough concentration was 15 mg/L or higher in patients with MRSA. In a retrospective, post hoc , subgroup analysis of a phase 3 trial for telavancin vs. vancomycin in S. aureus ‐induced nosocomial pneumonia, no significant difference was found in clinical cure rate and death rate across various vancomycin trough levels.…”