Grant: Project Grant

Intravenous vancomycin is an antibiotic used to treat methicillin-resistant Staphylococcus aureus (MRSA) infections. Vancomycin requires drug level monitoring in the blood. In the newest guideline, vancomycin should be dosed using a model of drug level over time, which is called area under the curve (AUC) of over 400. This is difficult to do as it requires complex calculations using an expensive software that takes time. A simpler way would be to target a trough level of 10-15mg/L that achieves AUC above 400 in most cases. We propose to conduct a randomized controlled trial to compare these two dosing strategies in patients with serious MRSA infections. The study will include patients admitted to Canadian hospitals with MRSA infection of the blood, brain, heart valve, lung, bone, joint or a deep-seated abscess who require vancomycin. Patients will be randomized to a dosing strategy based on the trough level or AUC. Patients will be followed over a 3-month period, with the aim of showing that the treatment success rate is similar between the two groups. If this is shown, the simpler trough-based strategy would be preferred.