Current status and prospects of therapeutic drug monitoring of vancomycin in the treatment of severe infections
Cao Wen
Abstract：Vancomycin is known as the last line of defense for treating Gram positive bacterial infections and is also recommended as a first-line medication.Due to its narrow treatment window,the critically ill patients need drug concentration monitoring for guiding safe medication in clinical treatment.Traditionally,therapeutic drug monitoring based on the trough concentration of vancomycin has been widely accepted in clinical practice.The 2009 Infectious Diseases Society of America(IDSA)guidelines recommended a targeted trough concentration of 15-20 mg/L for critically ill patients.In the past decade,domestic and foreign scholars have had varying evaluations of the safety and effectiveness of this treatment concentration.The 2020 updated guidelines propose that the most accurate and optimal drug administration method for the mimimal risk of kidney injury is guiding the dosage and monitoring through the area under the ROC curve(AUC),accompany with an individualized targeted AUC/minimal inhibitory concentration(MIC)ratio of 400-600 mg/(h·L).From this,it can be seen that there is currently controversy over the indicators for monitoring vancomycin treatment drugs.Therefore,this article reviews the methods and strategies for monitoring the treatment concentration of vancomycin in the treatment of severe infections,which is of great significance for guiding clinical rational drug use and helping clinical physicians develop personalized drug delivery plans to minimize or avoid drug toxicity.
Keywords：VancomycinSevere infectionPharmacokineticsPharmacodynamicsTherapeutic drug monitoringTrough concentrationArea under curve(AUC)
Publication Date：2024-02-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 171-176 )