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Gustavo Faulhaber, MD; Alexandre Zavascki, PhD; Sandra Costa Fuchs, MD, PhD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the article by Hidayat et al¹ that assessed the efficacy of vancomycin for the treatment of MRSA achieving unbound target serum trough levels of 4 or more times the minimal inhibitory concentration (MIC). The authors found that high MIC (1.5-2.0 µg/mL) was an independent predictor of poor clinical response regardless of the achievement of the aimed vancomycin trough levels.¹ However, besides the issue of the heteroresistance to vancomycin that was not assessed in the study, but was properly addressed in the "Comment" section, there are some important points not considered by the authors that could potentially determine biased results.

First, in the high MIC group, there was a significantly higher frequency of isolates recovered from blood (18/24 [75%] vs 6/24 [25%] in the high vs low MIC groups; P = .001), and most of these (20/24 . . . [Full Text of this Article]

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