Predictors of mortality for methicillin-resistant Staphylococcus aureus health-care-associated pneumonia: specific evaluation of vancomycin pharmacokinetic indices.
Chest
; 130(4): 947-55, 2006 Oct.
Article
em En
| MEDLINE
| ID: mdl-17035423
ABSTRACT
OBJECTIVE:
The goal of this investigation was to determine whether vancomycin pharmacokinetic indexes (eg, serum trough concentrations or area under the concentration curve [AUC] values) were associated with mortality for patients with health-care-associated pneumonia (HCAP) attributed to methicillin-resistant Staphylococcus aureus (MRSA).DESIGN:
A retrospective, single-center, observational cohort study.SETTING:
Barnes-Jewish Hospital, a 1,200-bed urban teaching facility. PATIENTS Adult patients requiring hospitalization who were identified as having HCAP attributed to MRSA by BAL semi-quantitative cultures.INTERVENTIONS:
Retrospective data collection from automated hospital, microbiology, and pharmacy databases. MEASUREMENTS AND MAINRESULTS:
One hundred two patients with MRSA HCAP were identified over a 6.5-year period. Thirty-two patients (31.4%) died during their hospitalization. The mean (+/- SD) vancomycin trough concentrations (13.6 +/- 5.9 vs 13.9 +/- 6.7 microg/mL, respectively; p = 0.866) and AUC values (351 +/- 143 vs 354 +/- 109 microg/h/mL, respectively; p = 0.941) did not differ between survivors and nonsurvivors. The stratification of the vancomycin trough concentrations and AUC values yielded no relationship with hospital mortality.CONCLUSIONS:
We found no evidence that greater vancomycin trough concentrations or AUC values correlated with hospital outcome. Based on these results, aggressive dosing strategies for vancomycin (eg, trough concentrations of > 15 microg/mL) may not offer any advantage over traditional dose targets (range, 5 to 15 microg/mL).
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Base de dados:
MEDLINE
Assunto principal:
Pneumonia Estafilocócica
/
Staphylococcus aureus
/
Vancomicina
/
Infecção Hospitalar
/
Resistência a Meticilina
/
Antibacterianos
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article