Martínková, J. (2015) Current view of vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. Klinická Mikrobiologie a Infekc̆ní Lékar̆ství. 21(1), p.16-23. [Article in Czech].
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The review article interprets recommendations for treating methicillin-resistant Staphylococcus aureus (MRSA) infections with vancomycin. These stem from a 2009 consensus followed by numerous preclinical and clinical studies carried out until now. They are based on defining the predictors of the bactericidal activity of vancomycin that are different from those in beta-lactam and aminoglycoside antibiotics. The predictors are AUC0-24/MIC >400 and Cₘᵢₙ. Practice requires recommendations on how to achieve maximum effectiveness and safety of vancomycin administered by intermittent vs. continuous infusion by setting target concentrations under dynamically changing conditions. Changes in the kinetics and dynamics of the antibiotic due to pathological covariates (SIRS, sepsis) and treatment should be detected as soon as possible by therapeutic monitoring aimed at individual adjustment of dosage.
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