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. 2016 Sep 27;5(4):34.
doi: 10.3390/antibiotics5040034.

Discrepancy in Vancomycin AUC/MIC Ratio Targeted Attainment Based upon the Susceptibility Testing in Staphylococcus aureus

Seenae Eum  1 , Robert L Bergsbaken  2 , Craig L Harvey  3 , J Bryan Warren  4 , John C Rotschafer  5
Affiliations

Discrepancy in Vancomycin AUC/MIC Ratio Targeted Attainment Based upon the Susceptibility Testing in Staphylococcus aureus

Seenae Eum et al. Antibiotics (Basel). .

Abstract

This study demonstrated a statistically significant difference in vancomycin minimum inhibitory concentration (MIC) for Staphylococcus aureus between a common automated system (Vitek 2) and the E-test method in patients with S. aureus bloodstream infections. At an area under the serum concentration time curve (AUC) threshold of 400 mg∙h/L, we would have reached the current Infectious Diseases Society of America (IDSA)/American Society of Health System Pharmacists (ASHP)/Society of Infectious Diseases Pharmacists (SIDP) guideline suggested AUC/MIC target in almost 100% of patients while using the Vitek 2 MIC data; however, we could only generate 40% target attainment while using E-test MIC data (p < 0.0001). An AUC of 450 mg∙h/L or greater was required to achieve 100% target attainment using either Vitek 2 or E-test MIC results.

Keywords: MIC; Staphylococcus aureus; susceptibility testing; vancomycin.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Vancomycin minimum inhibitory concentration (MIC) distribution comparison between Vitek 2 method and E-test method. Abbreviations: MIC, minimum inhibitory concentration.
Figure 2
Figure 2
Frequency distribution of vancomycin area under the serum concentration time curve to minimum inhibitory concentration (AUC/MIC) ratio targeted attainment for each assumed AUC. The asterisk mark indicates statistical significance. ** p < 0.001; * p < 0.01 for McNemar’s test. Abbreviations: AUC, area under the serum concentration time curve.
Figure 3
Figure 3
Frequency distribution of vancomycin area under the serum concentration time curve to minimum inhibitory concentration (AUC/MIC) ratio targeted attainment for each assumed AUC (a) in MRSA; (b) in MSSA. The asterisk mark indicates statistical significance. ** p < 0.001; * p < 0.05 for McNemar’s test. Abbreviations: AUC, area under the serum concentration time curve.
See this image and copyright information in PMC

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