Continue en intermitterende infusie van vancomycine even effectief

OBJECTIVE: To compare the efficacy of continuous vancomycin infusion with intermittent vancomycin infusion based on clinical endpoints.

DESIGN: Systematic review of the literature.

METHOD: Sixty articles on comparative studies on continuous and intermittent vancomycin infusion were found in Pubmed. Of these, the English-language articles on studies in adults were selected. Only articles in which a comparison was made in terms of clinical endpoints were included.

RESULTS: Six studies were included in which the differences between continuous and intermittent infusions were assessed in terms of the clinical endpoints. In the 2 prospective studies, no statistically significant differences in efficacy between the two methods of administration were found. A prospective study and retrospective study suggested that continuous infusion of high-dose vancomycin in patients with osteomyelitis may be more effective than intermittent infusion. There were no clear differences in side effects, although nephrotoxicity seemed to occur less rapidly and less often with continuous vancomycin infusion.

CONCLUSION: The available literature showed that continuous infusion of vancomycin is as effective as intermittent administration. In addition, continuous administration is cheaper and monitoring of serum levels is simpler. This offers the possibility of discharging specific patients more quickly from hospital and facilitates home care with vancomycin.