Conclusions (2/3) ...
In the absence of etiologic diagnostic or knowledge of likely MIC:
use vancomycin at full dose (1 g / 12h) and consider monitoring in
- elderly
- concurrent nephrotoxic drugs
- prolonged course ( > 1 week)
- patients necessitating high doses (high MIC, PK abnormal.)
- patients with rapidly changing renal function
but DO monitor in
- patients with suspected abnormal Vd or Cl
- anephric patients (hemodialysis)
- ICU patients with dobutamine, dopamine, furosemide, hemofiltration, burns, IVDU
but creatinine may do the job