Should higher vancomycin trough levels be targeted for invasive community-acquired methicillin-resistant Staphylococcus aureus infections in children?

Methicillin-resistant Staphylococcus aureus isolates with vancomycin minimal inhibitory concentrations (MICs) >or=1.5 microg/mL have been associated with poorer clinical outcomes and treatment failures in adults. We evaluated vancomycin MICs in 71 invasive pediatric community-acquired MRSA isolates from 2004 to 2008, using the E-test micromethod and the E-test macro-method. The modal MIC by micromethod was 1.5 microg/mL, and median vancomycin MICs did not increase over time.