1. Continuous infusion of vancomycin in methicillin-resistant staphylococcus infection
- Author
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A. R. De Gaudio, A Di Filippo, C Pelagatti, Gian Paolo Novelli, Paola Livi, Andrea Novelli, and Paternostro E
- Subjects
Adult ,Male ,Micrococcaceae ,Meticillin ,medicine.drug_class ,Antibiotics ,medicine.disease_cause ,Microbiology ,Vancomycin ,Drug Discovery ,medicine ,Humans ,Pharmacology (medical) ,Infusions, Intravenous ,Antibacterial agent ,Aged ,Retrospective Studies ,Pharmacology ,Aged, 80 and over ,biology ,business.industry ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,Middle Aged ,Staphylococcal Infections ,bacterial infections and mycoses ,biology.organism_classification ,Glycopeptide ,Anti-Bacterial Agents ,Infectious Diseases ,Oncology ,Female ,Methicillin Resistance ,business ,Staphylococcus ,Staphylococcus infection ,medicine.drug - Abstract
Objective: The aim of the study was to verify the therapeutic response of vancomycin in methicillin-resistant staphylococcus infection (MRSA/MRCNS) administered according to two different methods (intermittent infusion vs. continuous infusion). Method: Experimental plan: retrospective study; study environment: university hospital, two intensive care units. Twenty-five critically ill patients submitted to antibiotic treatment with vancomycin for infection from MRSA/MRCNS were studied. The patients, who were classified according to SAPS II scores, were divided into two groups: group A (n = 14): dose of vancomycin of 0.5 g × 4/day and group B (n = 11): dose of 2 g/day of vancomycin administered in a continuous infusion. Before the antibiotic therapy was started (T1) and prior to its end (T2), the following parameters were evaluated: degree of impairment of the main organs and systems by means of sepsis-related organ failure assessment score (SOFA) and count of the white blood cells (WBC). The length of the hospital stay during intensive care was calculated for both groups (statistics: Student t test). Results: No significant differences were found in the SAPS II scores and in the length of the hospital stay. In a comparison of the T1 and T2 results, we noted that patients of group A had no variations in the SOFA scores (4.84 ± 2.48 vs. 4 ± 3.9) and in the WBC mean values (12,415 ± 5,099 vs. 12,841 ± 6,864 cells/mm3). In contrast, in the patients of group B, we noted significant variations (p < 0.05) in the mean values of the SOFA scores (6.62 ± 2.2 vs. 4.37 ± 3.5) and in the mean values relative to the WBC count (17,242 ± 12,842 vs. 10,757 ± 3,610 cells/mm3). Conclusions: In critically ill patients suffering from MRSA/MRCNS infection, vancomycin administration in continuous infusions improved organ function and leukocyte response, but did not seem to modify the overall evolution of the disease.
- Published
- 1998