Annie Wong-Beringer

TL;DR: High prevalence of clinical MRSA strains with elevated vancomycin MIC (2 microg/mL) requires aggressive empirical vancomYcin dosing to achieve a trough greater than 15 microg /mL, and Combination or alternative therapy should be considered for invasive infections caused by these strains.

TL;DR: The primary recommendations consisted of eliminating routine monitoring of serum peak concentrations, emphasizing a ratio of area under the curve over 24 hours to minimum inhibitory concentration (AUC/ MIC) of ≥400 as the primary PK/ PD predictor of vancomycin activity, and promoting serum trough concentrations of 15 to 20 mg/L as a surrogate marker for the optimal vancomYcin AUC/MIC if the MIC was ≤1mg/L in patients with normal renal function.

TL;DR: Until superior efficacy is clearly shown (for documented infections) or pharmacoeconomic analyses document the value of these drugs, use of such expensive agents should be highly restricted to those who are intolerant of or refractory to AmBd.

TL;DR: The Etest method appears to be relatively more reliable in predicting treatment response and yielded higher MICs for strains with a hGISA phenotype, while VAN MIC testing methods produce highly variable results.

TL;DR: Saccharomyces boulardii probiotics should be used with caution for management of Clostridium difficile infections in hospitalized patients.