Article
Pharmacology & Pharmacy
Wasan Katip, Siriporn Okonogi, Peninnah Oberdorfer
Summary: This study evaluated the relationship between vancomycin trough levels and mortality, clinical outcomes, microbiological outcomes, and nephrotoxicity in patients with enterococcal infections. The results showed that a vancomycin trough of >= 15 mg/L was associated with lower mortality, better clinical and microbiological response, but higher nephrotoxicity. However, very high trough levels (>20 mg/L) were also associated with increased nephrotoxicity.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Microbiology
Lu Cao, Zhuo Li, Peng Zhang, Suyun Yong
Summary: This study found through meta-analysis that vancomycin trough concentrations within the range of 10-15 μg/mL can improve clinical efficacy in children, but concentrations exceeding 15 μg/mL should be avoided to reduce the incidence of adverse reactions.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Article
Microbiology
Heather D'Amico, Katie L. Wallace, Donna Burgess, David S. Burgess, Sarah Cotner, Ryan Mynatt, Nannan Li, Arnold Stromberg, Jeremy VanHoose
Summary: This study found that monitoring vancomycin treatment using AUC(24) was associated with a decreased risk of acute kidney injury in obese patients.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Article
Chemistry, Medicinal
Xiaohui Huang, Ze Yu, Shuhong Bu, Zhiyan Lin, Xin Hao, Wenjun He, Peng Yu, Zeyuan Wang, Fei Gao, Jian Zhang, Jihui Chen
Summary: This study established an optimal model to predict vancomycin trough concentrations using machine learning, selecting five algorithms with good performance and achieving the best result through model ensembling. Compared with pharmacokinetic models, the machine learning model showed better fitting and prediction accuracy.
DRUG DESIGN DEVELOPMENT AND THERAPY
(2021)
Article
Infectious Diseases
Welder Zamoner, Karina Zanchetta Cardoso Eid, Lais Maria Bellaver de Almeida, Isabella Goncalves Pierri, Adriano dos Santos, Andre Luis Balbi, Daniela Ponce
Summary: This study suggests that higher serum concentrations of vancomycin are associated with acute kidney injury in critically ill septic patients, preceding the diagnosis by at least 48 hours. It can be a useful monitoring tool when AUC cannot be used.
Article
Immunology
Yufei Shi, Bryan T. Alexander, Sean Avedissian, Scott J. Bergman, Nicolas Cortes-Penfield
Summary: Area under the curve (AUC)-based vancomycin dosing reduces nephrotoxicity but is burdensome. Reviewing 115 adults receiving >= 2 weeks of outpatient vancomycin, we found AUC-based and trough-based dose adjustments discordant only for troughs 16 mg/L. Selective versus universal outpatient AUC calculation would likely offer similar benefit with reduced workload.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Review
Infectious Diseases
Moeko Tsutsuura, Hiromu Moriyama, Nana Kojima, Yuki Mizukami, Sho Tashiro, Sumika Osa, Yuki Enoki, Kazuaki Taguchi, Kazutaka Oda, Satoshi Fujii, Yoshiko Takahashi, Yukihiro Hamada, Toshimi Kimura, Yoshio Takesue, Kazuaki Matsumoto
Summary: This systematic review and meta-analysis investigated the relationship between VCM monitoring strategies and its effectiveness and safety. Findings suggest that VCM trough concentrations and AUC values are correlated with outcomes. AUC-guided monitoring may have potential in reducing nephrotoxicity compared to trough-guided monitoring.
BMC INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Qingze Gu, Nicola Jones, Philip Drennan, Tim Ea Peto, A. Sarah Walker, David W. Eyre
Summary: This study evaluated the effectiveness of an antimicrobial guideline for vancomycin prescribing using electronic prescribing aid and web/phone-based app. The compliance with the guideline for dosing was generally good, but the proportion of drug levels reaching the target range was suboptimal. The study also suggests that routinely collected electronic healthcare record data can be used to refine antimicrobial dosing recommendations.
JOURNAL OF INFECTION
(2022)
Article
Medicine, General & Internal
Longzhu Li, Luming Zhang, Shaojin Li, Fengshuo Xu, Li Li, Shuna Li, Jun Lyu, Haiyan Yin
Summary: The study using a large public database found a relationship between patients' first vancomycin trough concentration (FVTC) and the occurrence of AKI, ICU mortality, and in-hospital mortality in critically ill patients.
FRONTIERS IN MEDICINE
(2022)
Article
Infectious Diseases
Sonya Tang Girdwood, Denise Hasson, J. Timothy Caldwell, Cara Slagle, Shun Dong, Lin Fei, Peter Tang, Alexander A. Vinks, Jennifer Kaplan, Stuart L. Goldstein
Summary: This study investigated the exposure of piperacillin/tazobactam in critically ill children and young adults, and identified clinical factors associated with piperacillin-associated acute kidney injury (AKI). The results showed that higher piperacillin AUC and highest C-min in the first 24 hours were associated with piperacillin-associated AKI, indicating the importance of early total piperacillin exposure in AKI development.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Article
Microbiology
Jack Chang, Gwendolyn M. Pais, Patti L. Engel, Patryk Klimek, Sylwia Marianski, Kimberly Valdez, Marc H. Scheetz
Summary: Vancomycin-induced kidney injury is common, and outcomes in humans are well predicted by animal models. This study employed our translational rat model to investigate temporal changes in the glomerular filtration rate (GFR) and correlations with kidney injury biomarkers related to various vancomycin dosing strategies.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2023)
Article
Infectious Diseases
Ayako Suzuki, Yukihiro Hamada, Hirokazu Ikeda, Hironori Tanaka, Mari Yanagihara, Mikako Namiki, Toru Watanabe, Tadanori Sasaki
Summary: The study found that both vancomycin trough concentration and AUC are significant risk factors for nephrotoxicity, and the incidence of nephrotoxicity can be reduced by controlling both vancomycin trough concentration and AUC, highlighting the importance of promoting antimicrobial stewardship.
JOURNAL OF INFECTION AND CHEMOTHERAPY
(2021)
Article
Pharmacology & Pharmacy
Krista A. Wahby, Lejla Cunmuljaj, Karim Mouabbi, Zinah Almadrahi, Liz Wilpula
Summary: The study aimed to evaluate vancomycin dosing practices for critically ill patients on CVVH, develop guidelines for optimal dosing, and reduce pharmacist workload. Results showed that scheduled vancomycin dosing improved target trough attainment and decreased pharmacist interventions.
Article
Pediatrics
Raissa Queiroz Rezende, Cicero Armidio Gomes Dias, Claudia Pires Ricachinevsky, Joao Paulo de Lucena Capelari
Summary: Vancomycin use in pediatric intensive care presents challenges, but clinical practice protocols can aid in dose adjustment and control for better outcomes, even without available monitoring technologies.
Article
Biochemistry & Molecular Biology
Hyun-Seung Lee, Sang-Mi Kim, Ja-Hyun Jang, Hyung-Doo Park, Soo-Youn Lee
Summary: The study found that the increased ratio of 5-hydroxyindoleacetic acid to serotonin may serve as a surrogate marker for VAKI, reflecting acute oxidative stress and inflammation.