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Prospective Evaluation of a Vancomycin Nomogram With a Continuous Infusion of Vancomycin for Surgical ICU Patients (CIV)

This study has been completed.
Information provided by (Responsible Party):
Hsin Jung Lin, Massachusetts General Hospital Identifier:
First received: February 4, 2013
Last updated: November 30, 2016
Last verified: November 2016

Vancomycin is an essential antimicrobial which is frequently used in the ICU for suspected methicillin-resistant Staphylococcus aureus (MRSA) infection. Therefore, it is vital to optimize the dosing of vancomycin for this critically ill population. The most efficacious method of administering vancomycin is debated in the literature. Since vancomycin is associated with slow bactericidal activity, it is important to closely monitor serum concentrations so as to achieve early target serum concentration, particularly when treating aggressive S. aureus infections. One study has shown that vancomycin infused continuously may enable faster and more consistent achievement of a therapeutic serum concentration when compared to intermittent infusion. A faster achievement in the goal serum vancomycin concentration would be a protective factor for intensive care unit mortality in patients with MRSA infection.

Currently in the surgical ICU (SICU) of our institute, vancomycin is administered based on a vancomycin dosing nomogram. Less than fifty percent of the ICU patients following this nomogram achieved target vancomycin concentration of 15 after 24 hours. To better achieve target vancomycin concentration in 24 hours, we developed a new vancomycin dosing nomogram with a continuous infusion. The aim is to determine which of the two dosing nomogram is more efficient and safer for SICU patients.

Condition Intervention Phase
MRSA - Methicillin Resistant Staphylococcus Aureus Infection
Drug: Vancomycin continuous infusion
Drug: Vancomycin intermittent dosing interval
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Prospective Evaluation of a Vancomycin Nomogram With a Continuous Infusion of Vancomycin for Surgical ICU Patients

Resource links provided by NLM:

Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • Frequency of achieving target vancomycin concentration [ Time Frame: 24 hours ]

Secondary Outcome Measures:
  • Incidence of nephrotoxicity [ Time Frame: 7 to 10 days ]
  • To establish the relationship of vancomycin clearance with renal clearance [ Time Frame: 7 to 10 days ]

Enrollment: 44
Study Start Date: September 2013
Study Completion Date: November 2016
Primary Completion Date: November 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Vancomycin with continuous infusion
continuous 24 hours intravenous infusion
Drug: Vancomycin continuous infusion
Vancomycin 24 hour intravenous continuous infusion
Active Comparator: Vancomycin with intermittent dose interval
infusion rate 1000mg/hr
Drug: Vancomycin intermittent dosing interval
Vancomycin intravenous infusion at rate 1000mg/hr


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male and non-pregnant female > 18 years of age admitted to Surgical ICUs with suspected infection
  • Calculated creatinine clearance > 60ml/min

Exclusion Criteria:

  • Age < 18 years
  • Allergic to vancomycin
  • Calculated creatinine clearance < 60ml/min
  • Pregnant
  • Vancomycin administration more than 8 hour and less than 24 hour prior to study enrollment
  • Anticipated vancomycin treatment less than 2 days for surgical prophylaxis
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Please refer to this study by its identifier: NCT01786161

United States, Massachusetts
Boston, Massachusetts, United States, 02116
Sponsors and Collaborators
Massachusetts General Hospital
Principal Investigator: Hsin Lin, PharmD Massachusetts General Hospital
  More Information

Responsible Party: Hsin Jung Lin, PharmD, Massachusetts General Hospital Identifier: NCT01786161     History of Changes
Other Study ID Numbers: P 002617
Study First Received: February 4, 2013
Last Updated: November 30, 2016

Additional relevant MeSH terms:
Staphylococcal Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Anti-Bacterial Agents
Anti-Infective Agents processed this record on April 26, 2017