Clinical Trials Logo
  1. Home
  2. MRSA
  3. NCT05395520

Vancomycin Monitoring: Is AUC Monitoring Appropriate for More Than Just Serious MRSA Infections?

MRSA Clinical Trial

Official title:
Vancomycin Monitoring: Is AUC Monitoring Appropriate for More Than Just Serious MRSA Infections?

Clinical Trial Summary

Vancomycin, a glycopeptide antibiotic, is commonly prescribed as initial therapy for hospitalized patients due to its broad gram-positive coverage. Vancomycin is used for the treatment and prevention of a variety of bacterial infections ranging from streptococcal to methicillin-resistant Staphylococcus aureus (MRSA) infections.1 Notable adverse effects of intravenous vancomycin include nephrotoxicity, ototoxicity and hypersensitivity reactions. Given its pharmacokinetic profile, therapeutic drug monitoring is essential in determining the therapeutic efficacy of vancomycin as well as for avoiding nephrotoxicity.

Clinical Trial Description

Vancomycin, a glycopeptide antibiotic, is commonly prescribed as initial therapy for hospitalized patients due to its broad gram-positive coverage. Vancomycin is used for the treatment and prevention of a variety of bacterial infections ranging from streptococcal to methicillin-resistant Staphylococcus aureus (MRSA) infections.1 Notable adverse effects of intravenous vancomycin include nephrotoxicity, ototoxicity and hypersensitivity reactions. Given its pharmacokinetic profile, therapeutic drug monitoring is essential in determining the therapeutic efficacy of vancomycin as well as for avoiding nephrotoxicity. The 2020 guidelines continue to enforce AUC/MIC as the preferred PK/PD parameter, but now recommend utilizing vancomycin peak and trough concentrations to target an AUC/MIC of 400-600 mg*h/L for serious MRSA infections. Although this AUC goal is not new, the 2009 consensus guidelines previously recommended trough only monitoring as a simplistic surrogate marker for attaining this AUC goal. Furthermore, the most accurate way of calculating AUC requires obtaining two steady state vancomycin serum concentrations over one dosing period. In this way, AUC guided monitoring requires more pharmacist and nursing time, the use of more hospital resources and additional cost to the patient. As was true of the 2009 guidelines, the 2020 guidelines also leave certain questions unanswered. The paucity and conflicting data of vancomycin monitoring in patients with non-serious MRSA infections (skin and soft tissue infections, urinary tract infections, etc.), methicillin-sensitive Staphylococcus aureus (MSSA) infections and non-staphylococcal pathogen infections has left no guidance on the ideal vancomycin PK/PD targets in these patient populations. A literature search of AUC/MIC monitoring in patients with streptococcal and enterococcal infections yielded very few studies in patients with enterococcal infections and no studies in patients with streptococcal infections. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT05395520
Study type Observational
Source Methodist Health System
Contact
Status Enrolling by invitation
Phase
Start date April 8, 2021
Completion date April 8, 2024
View Details
See also
  Status Clinical Trial Phase
Completed NCT03181932 - AeroVanc in the Treatment of Methicillin-resistant Staphylococcus Aureus Infection in Patients With Cystic Fibrosis Phase 3
Completed NCT03268122 - Comparison of Standard Isolation With Targeted Isolation for Preventing Nosocomial Transmission of MRSA and VRE N/A
Completed NCT04312776 - Tracing MRSA in Households With Patients Infected With CA-MRSA by WGS
Recruiting NCT04104178 - Optimal Treatment of MRSA Throat Carriers Phase 3
Recruiting NCT04793152 - Vancomycin Dosing for Serious MRSA Infections: A Non-inferiority Randomized Trial of Trough Level Versus AUC/MIC N/A
Completed NCT03601741 - Use of Disposable Stethoscope Covers for Reduction of Stethoscope MRSA Contamination N/A
Completed NCT02690415 - Community-Assoc. S. Aureus Colonization and Recurrent Infection in Pts With Uncomplicated S. Aureus Skin Abscesses
Enrolling by invitation NCT04297592 - Antibiotic Prophylaxis in High-Risk Arthroplasty Patients Phase 4
Recruiting NCT05268120 - MRSA Decolonization in Complicated Carriage N/A
Completed NCT01167452 - Effect of Weight and/or Obesity on Sulfamethoxazole and Trimethoprim Concentrations Phase 4
Recruiting NCT04083092 - Surveillance of Community-Associated MRSA
Recruiting NCT02443064 - Pharmacokinetics/ Pharmacodynamics (PK/PD) Study of Vancomycin Phase 4
Completed NCT02029872 - Stop Community MRSA Colonization Among Patients Phase 4
Not yet recruiting NCT05696132 - Evaluation of the Decolonization Rate and Acceptance of a Complete Nasal Decolonization Kit With Povidone Iodine for MRSA Patients Phase 2
Recruiting NCT02127658 - MRSA Eradication and Decolonization in Children N/A
Completed NCT00822276 - The Underlying Mechanisms For S. Aureus Infection And Colonization Of Skin in People With Atopic Dermatitis With And Without Eczema Herpeticum (MRSA) N/A
Withdrawn NCT02547116 - Epidemiology and Treatment of Small-colony Variant Staphylococcus Aureus in Cystic Fibrosis Phase 4
Completed NCT01318213 - Benefits of Universal Glove and Gowning
Completed NCT03304873 - Retapamulin as a Decolonizing Agent for MRSA Phase 3