[Intravenous vancomycin therapy of adults guided by pharmacokinetic-pharmacodynamic targets]

Multidrug-resistant pathogens and those with extended antimicrobial resistance significantly burden the healthcare system. The introduction of anti-infective therapy protocols that flexibly ensure effective treatment and the suppression of the evolution of resistant strains of pathogens has become an urgent task. Therapeutic drug monitoring (TDM), which has recently developed into a multidisciplinary field, makes a significant contribution. Vancomycin is used worldwide in inpatient wards for suspected or documented infections caused by Gram-positive pathogens. The currently generally accepted consensus recommendation for the treatment of severe MRSA infections with vancomycin presents in detail the aspects of the clinical use of the drug in addition to TDM for different patient populations (critically ill, obese, and patients receiving renal replacement therapy). Based on existing guidelines and available calculator software, treatment can be individualized from its most critical early stage. We aim to summarize the views and recommendations formulated in the consensus guideline, integrate these into subsequent scientific publications, and facilitate their clinical implementation to take us closer to a harmonized practice in Hungary. We also aim to present the perspectives of using vancomycin pharmacokinetic calculators. Finally, we make methodological recommendations for individualized decisions regarding vancomycin therapy in adult care. Orv Hetil. 2025; 166(17): 638–651.