Vancomycin max daily dose

[StaviZFingerZ]

Advertisement - Members don't see this ad

You mean the one where it was compared to imipenem and if/when pseudomonas was a concern the tigecycline arm was given the mighty aztreonam and if MRSA was a concern the imipenem arm was given vanco?

Took you long enough to google that. Yup look at the MRSA arm.

And bacteremia does play a huge role as usually the serum levels of tigecycline is below most gm- MICs and usually only the peak level is above the MIC for gm+.

In your mind maybe. But where are the bugs in pneumonia? Typicals vs. Atypicals. Better yet where are the MRSA and can Tygacil get there?

EDIT: would never use tigecycline in a real patient unless no other option and while it seems like i'm "defending" tigecycline, I'm not like a employee of wyeth or pfizer or whoever owns it now, just speaking in the hypothetical realm of SDN.

Then stop playing devil's advocate while making little sense.

 

[thedrunkenpharm]

The study done by Tom Lodise (http://cme.medscape.com/viewarticle/563971) is where I found risk with high doses of vanc.

 

[StaviZFingerZ]

debatable.........

the only outcome that showed a difference was "clinical cure" which had to include a >50% improvement by Xray reading....

why debatable?

It's an open-label study and any % improvement in an Xray reading is going to be subjective and variable. Were the Xrays read by the same people? were the people who read the xrays the investigators (and hence by showing a "difference" are more likely to get published and their name out there)

That's why it's an option not a class 1 evidence. But when all else fail are you going to cite your reasoning to not try it? Speaking anecdotally, my buddy ID uses bactrim and/or rifampin quite often on MRSA patients when d/c from inpatient.

 

[njac]

My ID guys use a fair amount of rifampin and minimal Bactrim

 

[Praziquantel86]

I've also seen a decent amount of rifampin, not necessarily for pneumonia though.

 

[gotdrugs]

.

 

[gotdrugs]

.

 

[gotdrugs]

.

 

[museabuse]

i typed my reply doing 70mph on I-10 in az.

Only 70 I do at least 80 and slow down for photo radar because they always warn you a half mile out. Not sure why they warn you though...

 

[nicolemsm]

i typed my reply doing 70mph on I-10 in az.

Do you practice in AZ?

 

[rxlea]

Only 70 I do at least 80 and slow down for photo radar because they always warn you a half mile out. Not sure why they warn you though...

They have to for "safety reasons"

 

[Its Z]

Do you practice in AZ?

I'm not licensed in AZ. But I do consulting nationwide.

 

[nicolemsm]

I'm not licensed in AZ. But I do consulting nationwide.

Want to hook me up with a tech job centrally located in AZ? I'm sure you know a lot of pharmacists here... right? right? 🙂😀

 

[Its Z]

Want to hook me up with a tech job centrally located in AZ? I'm sure you know a lot of pharmacists here... right? right? 🙂😀

Nothing in Central AZ. There are pockets in AZ with a severe pharmacist shortage.