Vancomycin Consensus 2020 — Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: revised consensus guideline
ASHP / IDSA / PIDS / SIDP, 2020
For serious MRSA infection, target AUC24/MIC 400–600 when MIC is assumed to be 1 mg/L and favor AUC-guided monitoring over routine trough-only 15–20 mg/L targeting. In critically ill adults, loading doses based on actual body weight may be used when rapid target attainment is needed; maintenance dosing requires individualized renal-function and drug-exposure assessment.
Clinical Context & Relevant Topics (3)
Disease ReferenceNosocomial pneumonia developing ≥ 48 hours after admission in non-ventilated patients, host and antibiogram MDR risk tailoring, nasal MRSA PCR screening, and 7-day de-escalation.
Quantitative lower tract sampling (ETA vs BAL), rapid multiplex PCR panels and stewardship interpretation, PK/PD extended beta-lactams, 7-day duration, and the SHEA prevention bundle.
The subset of sepsis with profound circulatory and cellular/metabolic abnormality — clinically identified by a vasopressor requirement to maintain MAP ≥ 65 mmHg plus lactate > 2 mmol/L despite adequate fluid resuscitation.