Retrospective, Multicentre Matched Cohort Study Comparing Safety and Efficacy Outcomes of Intermittent Infusion and Continuous Infusion Vancomycin

Patients with good renal function receiving intermittent infusion vancomycin (IIV) may require total daily doses ≥4g to achieve trough concentrations of 15-20mg/L, increasing the risk of vancomycin associated nephrotoxicity (VAN). Continuous infusion vancomycin (CIV) may attain concentrations of 15-20mg/L with lower daily vancomycin doses, potentially reducing the risk of VAN. A retrospective chart review for eligible patients admitted to hospital between January 1, 2010 and December 31, 2016 was completed. Adult patients receiving >48 hours of vancomycin with ≥1 steady state vancomycin concentration were eligible. The primary outcome was to compare the rates of nephrotoxic risk and renal injury, defined by the RIFLE criteria, between CIV and IIV. Of 2136 patients identified, 146 CIV patients were identified and matched to 146 IIV patients. CIV was found to have a lower odds of developing nephrotoxic risk (odds ratio [OR] 0.42, 95% confidence interval [CI]0.21-0.98) and renal injury (OR 0.19, 95% CI 0.05-0.59, p=0.004).M.Sc