PURPOSE: VAP is a common nosocomial infection associated with adverse hospital outcomes. MRSA is the pathogen identified in a third of the patients. Vancomycin has been the accepted standard therapy, however, high clinical failure rates are reported. Whether better outcomes can be achieved targeting higher trough concentrations remains unknown. The purpose of this study is to determine if outcomes of patients with MRSA VAP are dependent on their respective vancomycin trough concentration.
METHODS: Patients with MRSA VAP diagnosed following the NNIS criteria were retrospectively reviewed. Hospital mortality was compared based on the initial vancomycin trough concentration. Data was analyzed using Fisher's exact test.
RESULTS: Thirty two patients were analyzed. Mean (± SD) age was 63 ± 15 years. APACHE II score was 15.3 ± 4.9 and ICU and hospital length of stay were 28.5 ± 16.3 and 38.8 ± 18.7 days, respectively. The overall survival rate was 63%. Serum creatinine concentration remained unchanged regardless of the vancomycin troughs.
CONCLUSION: Hospital survival of patients with MRSA VAP appears dependent on achieving vancomycin trough concentrations ≥ 16 μg/mL.
CLINICAL IMPLICATIONS: Vancomycin trough concentrations ≥ 16 μg/ml may positively impact hospital outcomes of patients with MRSA ventilator associated pneumonia.
DISCLOSURE: Faris Khasawneh, No Financial Disclosure Information; No Product/Research Disclosure Information