Comparison of Continuous Infusion versus Intermittent Infusion of Vancomycin in Patients with Methicillin-Resistant Staphylococcus aureus
Sutep Jaruratanasirikul MD*, Jakrawadee Julamanee MD*, Teeratad Sudsai MSc*, Phanvasri Saengsuwan MSc*, Monchana Jullangkoon MPharm*, Natnicha Ingviya BSc**, Roongrueng Jarumanokul MSc**
Affiliation : * Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand ** Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective : To compare the pharmacokinetics of vancomycin administration by continuous infusion and
intermittent infusion.
Material and Method: A prospective, randomized, two-way crossover study of 12 patients with methicillin-
resistant Staphylococcus aureus infections was conducted. All patients were randomized to receive vancomycin
in both regimens consecutively: (i) infusion of 15 mg/kg of vancomycin as a loading dose for 1 h followed by
30 mg/kg of vancomycin as a continuous infusion over 24 h for 48 h; and (ii) intermittent infusion of 15 mg/kg
of vancomycin for 1 h every 12 h for 48 h. Vancomycin pharmacokinetic studies were carried out during hours
24-48 after the start of both regimens.
Results : For the continuous infusion regimen, the mean highest steady-state concentration was 24.88 + 12.75
μg/ml and the mean lowest steady-state concentration was 19.89 + 10.15 μg/ml. For the intermittent infusion
regimen, the mean peak and trough serum concentrations were 55.02 + 17.36 and 12.43 + 12.86 μg/ml,
respectively. After 10 days of vancomycin treatment, the MRSA infections were eradicated in all patients.
Moreover, during both methods of infusion, no adverse events related to the use of vancomycin were observed.
Conclusion : Either continuous infusion or intermittent infusion can be used as an effective mode of vancomycin
administration to achieve bactericidal activity.
Keywords : Vancomycin, Continuous infusion, Intermittent infusion
