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James R. Johnson, MD

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Although the study by Hawkins et al¹ provides valuable new information regarding the epidemiologic features of persistent Staphylococcus aureus bacteremia (pSAB), it leaves certain important questions unanswered and is potentially misleading regarding others. First, the authors state that vancomycin drug levels were "not determined " in their study, precluding comment on the relationship between vancomycin levels and outcomes, which, as noted by the authors,¹ is an important and currently controversial topic. It is hard to imagine that vancomycin levels truly were not obtained for their subjects as a part of routine clinical care. Presumably, in their study, "not determined " means "not extracted during the medical record review." This would seem to be a significant omission but one that could be readily remedied by a focused search of laboratory records. Such an analysis might provide insights into whether more aggressive vancomycin dosing can prevent pSAB or . . . [Full Text of this Article]

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