A Quasi-Experiment To Study the Impact of Vancomycin Area under the Concentration-Time Curve-Guided Dosing on Vancomycin-Associated Nephrotoxicity

Antimicrobial Agents and Chemotherapy
Natalie A FinchM J Rybak

Abstract

Evidence suggests that maintenance of vancomycin trough concentrations at between 15 and 20 mg/liter, as currently recommended, is frequently unnecessary to achieve the daily area under the concentration-time curve (AUC24) target of ≥400 mg · h/liter. Many patients with trough concentrations in this range have AUC24 values in excess of the therapeutic threshold and within the exposure range associated with nephrotoxicity. On the basis of this, the Detroit Medical Center switched from trough concentration-guided dosing to AUC-guided dosing to minimize potentially unnecessary vancomycin exposure. The primary objective of this analysis was to assess the impact of this intervention on vancomycin-associated nephrotoxicity in a single-center, retrospective quasi-experiment of hospitalized adult patients receiving intravenous vancomycin from 2014 to 2015. The primary analysis compared the incidence of nephrotoxicity between patients monitored by assessment of the AUC24 and those monitored by assessment of the trough concentration. Multivariable logistic and Cox proportional hazards regression examined the independent association between the monitoring strategy and nephrotoxicity. Secondary analysis compared vancomycin exposures (total...Continue Reading

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Apr 1, 1984·Antimicrobial Agents and Chemotherapy·G R MatzkeW F Keane
Oct 1, 1994·Therapeutic Drug Monitoring·M P DucharmeD J Edwards
Aug 18, 2004·Critical Care : the Official Journal of the Critical Care Forum·Rinaldo BellomoUNKNOWN Acute Dialysis Quality Initiative workgroup
Jan 30, 2008·Antimicrobial Agents and Chemotherapy·Thomas P LodiseG L Drusano
Mar 13, 2008·The Journal of Antimicrobial Chemotherapy·Paul R IngramDale A Fisher
Jul 10, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas P LodiseGeorge L Drusano
Apr 5, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ravina KullarMichael J Rybak
Sep 29, 2011·Antimicrobial Agents and Chemotherapy·John A BossoPatrick D Mauldin
Jan 22, 2013·Antimicrobial Agents and Chemotherapy·Natasha E HolmesPaul D R Johnson
Oct 30, 2013·Antimicrobial Agents and Chemotherapy·Michael N NeelyThomas P Lodise
May 29, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas P LodiseLouise-Anne McNutt
Jun 10, 2014·Advanced Drug Delivery Reviews·Manjunath P PaiThomas P Lodise
Jul 5, 2015·International Journal of Antimicrobial Agents·Timothy HanrahanJason A Roberts
Aug 28, 2015·Anaesthesia and Intensive Care·T P HanrahanA Udy
Nov 20, 2015·Journal of the Pediatric Infectious Diseases Society·Jennifer LeJohn Bradley
Dec 15, 2015·International Journal of Antimicrobial Agents·Jing-Jing HaoJian-Xin Zhou
Mar 2, 2016·Therapeutic Drug Monitoring·Erik M van MaarseveenArthur R H van Zanten
May 29, 2016·International Journal of Antimicrobial Agents·Daniel Echeverría-EsnalSantiago Grau
Dec 18, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Bhagyashri NavalkeleKeith S Kaye

❮ Previous
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Citations

Mar 2, 2018·Therapeutic Drug Monitoring·Paul Lewis
Nov 1, 2017·Antimicrobial Agents and Chemotherapy·Evan J ZasowskiMichael J Rybak
Apr 25, 2018·Antimicrobial Agents and Chemotherapy·Saeed A AlqahtaniTurki B Albacker
Jul 20, 2018·Journal of Clinical Pharmacology·Evan J Zasowski, Thomas P Lodise
Aug 14, 2018·Journal of Pharmacy Practice·Erik W SkoglundKady Phe
Nov 14, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Xiaoyu LiangHong Zhang
Oct 20, 2018·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Emily L HeilJason M Pogue
Feb 5, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Doaa M AljefriMarc H Scheetz
Jun 4, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Keith A Rodvold
Jul 26, 2019·Journal of the Pediatric Infectious Diseases Society·Jared OlsonEmily A Thorell
Oct 18, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Lina Meng
Jan 21, 2020·Pharmacotherapy·Anne M MasichMathangi Gopalakrishnan
Dec 14, 2019·European Journal of Clinical Pharmacology·Nathan BatchelderJeremy Frens
Oct 23, 2019·The Journal of Applied Laboratory Medicine·Mark J BiagiEric Wenzler
Aug 14, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sarah C J JorgensenMichael J Rybak
Aug 14, 2020·The Journal of Antimicrobial Chemotherapy·Rashmi V ShingdeSophie L Stocker
Jul 14, 2018·Journal of Clinical Pharmacy and Therapeutics·Paul O LewisDavid B Cluck
Sep 12, 2018·The Journal of Antimicrobial Chemotherapy·Ryan L CrassManjunath P Pai
Nov 14, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kai ShenJing Zhang
Aug 20, 2019·Journal of Pharmacy Practice·Eric R GregoryKatie L Wallace
Apr 9, 2020·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Heather L Girand
Jun 5, 2020·British Journal of Clinical Pharmacology·Luqman ValiHussain Mulla
May 8, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Wesley D KufelJeffrey M Steele
Jun 17, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jaclyn A CusumanoKerry L LaPlante
Nov 12, 2019·Journal of Pharmacy Practice·Meagan M LangtonJulie MacDougall
May 10, 2020·Intensive Care Medicine·Mohd H Abdul-AzizUNKNOWN Infections in the ICU and Sepsis Working Group of International Society of Antimicrobial Chemotherapy (ISAC)
Sep 26, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David E NixKathryn R Matthias
Apr 3, 2020·Annals of Clinical Microbiology and Antimicrobials·Luigi BrunettiDong-Churl Suh

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