Vancomycin dosing and monitoring 2 years after the guidelines.

Administration of vancomycin continues to be common despite perceived concerns of increased MICs, treatment failures and toxicity. In 2009, a consensus guideline was published in an effort to optimize dosing and monitoring of this useful agent. It was unique in targeting a specific antibiotic rather than a disease state or organism. However, a lack of prospective randomized double-blinded trials upon which to base guidelines was noted. In addition, several questions were raised and remain unanswered. Since guideline publication, new data has added to our understanding of the implications of aggressive dosing and subsequent monitoring. The following article discusses research published within the last 2 years.