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Annie Wong-Beringer, PharmD; Levita K. Hidayat, PharmD; Donald I. Hsu, PharmD

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We are pleased to capture the attention of our colleagues and appreciate the opportunity to provide further discussions related to our prospective observational study examining the efficacy and safety of high-dose vancomycin therapy for the treatment of MRSA.¹ Johnson requested definitions of "target" and "corrected" troughs used and an explanation of the outcome analysis performed in our study. Target trough was defined as achievement of an unbound vancomycin concentration at 4 to 5 times the MIC of the infected strain.^1(p2139) Thus, for a strain with an MIC of 2 µg/mL and taking into account the 50% protein-binding property of vancomycin, attaining a target trough of 16 to 20 µg/mL is necessary to achieve 4 to 5 times the MIC of the infected strain, respectively (eg, bound + unbound drug concentration of 16 µg/mL = 2 µg/mL x 2 x 4). To . . . [Full Text of this Article]

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