Vancomycin Dosing for Serious MRSA Infections: A Non-inferiority Randomized Trial of Troug
Intravenous vancomycin is considered first line therapy for serious methicillin-resistant Staphylococcus aureus (MRSA) infections including bacteremia, central nervous system infection, pneumonia, pleural space infection, bone or joint infection, prosthetic joint infection and deep abscesses. The effectiveness and toxi
| Condition(s) | MRSA |
|---|---|
| Status | Recruiting |
| Phase | NA |
| Study type | Interventional |
| Summary | Intravenous vancomycin is considered first line therapy for serious methicillin-resistant Staphylococcus aureus (MRSA) infections including bacteremia, central nervous system infection, pneumonia, pleural space infection, bone or joint infection, prosthetic joint infection and deep abscesses. The effectiveness and toxicity of vancomycin depend on its dosing and chosen target. The most recent guidelines suggest targeting area under the curve over 24 hours over minimum inhibitory concentration (AUC/MIC) of 400 to 600. Implementation of AUC/MIC requires Bayesian software that can be variable, costly, complicated and time consuming. Ideally, AUC/MIC dosing would also require susceptibility testing by broth microdilution, which is not commonly done. It is recommended to target AUC of 400 to 600 |
| Who can participate | Inclusion Criteria: * Adult patients with serious MRSA infections based on culture results including bacteremia, pneumonia, pleural space infection, central nervous system infection, bone infection, septic arthritis, prosthetic joint infection, and deep abscess * Enrolment within 4 days from date of MRSA culture collection * Patient either currently not on vancomycin or has received vancomycin for 4 days or less Exclusion Criteria: * Vancomycin minimum inhibitory concentration (MIC) ≥2ug/mL * Patient is palliative or expected to die in the next 48 hours, or requires critical care resources but will not receive it due to advanced care directives * History of type 1 hypersensitivity reaction to vancomycin * Patients on intermittent hemodialysis or peritoneal dialysis |
| Ages | 18 Years |
| Sex | All |
| Lead sponsor | Anthony Bai |
| Locations | Hamilton, Ontario, Canada; Hamilton, Ontario, Canada; Kingston, Ontario, Canada; Montreal, Quebec, Canada |
| Start date | 2023-03-20 |
| NCT ID | NCT04793152 |
| Official listing | https://clinicaltrials.gov/study/NCT04793152 |