ReviewThe American journal of medicine2010
Vancomycin-associated nephrotoxicity: grave concern or death by character assassination?
Review in The American journal of medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03586362 (Vancomycin De-escalation Therapy in Patients With Pneumonia and Negative MRSA Nasal Swab), which is not on this map. Cited by 50 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Vancomycin De-escalation Therapy in Patients With Pneumonia and Negative MRSA Nasal Swab
Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 142 citations in OpenAlex.
- Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter.Antimicrobial agents and chemotherapy · 2013Pooled it
- Trial
- Vancomycin therapeutic drug monitoring is associated with reduced toxicity in ICU patients: a MIMIC-IV retrospective study.Scientific reports · 2026Article
- A Comparative Review of the Pharmacology of Dalbavancin and Oritavancin for Gram-Positive Infections: Birds of a Feather or Apples and Oranges?Infectious diseases and therapy · 2025Review
- Vancomycin dosing design method considering risk factors for nephrotoxicity.Journal of pharmaceutical health care and sciences · 2025Article
- Implementing AUC Monitoring in a Pharmacist-Managed Vancomycin Dosing Protocol: A Retrospective Cohort Study.HCA healthcare journal of medicine · 2023Article
- Vancomycin Resistance inMicroorganisms · 2022Review
- Review
- Impact of combining vancomycin with piperacillin/tazobactam or with meropenem on vancomycin-induced nephrotoxicity.Internal and emergency medicine · 2021Article
- Evaluation of a trough-only extrapolated area under the curve vancomycin dosing method on clinical outcomes.International journal of clinical pharmacy · 2021Article
- Nephrotoxins and nephrotoxic acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2020Review
- Pharmacist-Driven MRSA Nasal PCR Screening and the Duration of Empirical Vancomycin Therapy for Suspected MRSA Respiratory Tract Infections.Mayo Clinic proceedings. Innovations, quality & outcomes · 2020Article
- Impact of Nasal Swabs on Empiric Treatment of Respiratory Tract Infections (INSERT-RTI).Pharmacy (Basel, Switzerland) · 2020Article
- Vitamin E in the prevention of vancomycin-induced nephrotoxicity.Research in pharmaceutical sciences · 2020Article
- Impact of total body weight on rate of acute kidney injury in patients treated with piperacillin-tazobactam and vancomycin.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2019Article
- Utilizing the Patient Care Process to Minimize the Risk of Vancomycin-Associated Nephrotoxicity.Journal of clinical medicine · 2019Review
- Assessment of vancomycin utilization among Lebanese hospitals.Saudi medical journal · 2019Article
- Optimizing Vancomycin Dosing in Chronic Kidney Disease by Deriving and Implementing a Web-Based Tool Using a Population Pharmacokinetics Analysis.Frontiers in pharmacology · 2019Article
- Evaluation of risk factors for vancomycin-induced nephrotoxicity.International journal of clinical pharmacy · 2018Observational
- Evaluation of apramycin activity against methicillin-resistant, methicillin-sensitive, and vancomycin-intermediate Staphylococcus aureus clinical isolates.Diagnostic microbiology and infectious disease · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
Vancomycin-associated nephrotoxicity was reported in 0% to 5% of patients in the 1980s. This has been confirmed by numerous clinical trials comparing novel anti-methicillin-resistant Staphylococcus aureus agents with vancomycin at the Food and Drug Administration-approved dosage of 1 g every 12 hours. Treatment failures of vancomycin in patients with methicillin-resistant S. aureus infections have been reported despite in vitro susceptibility. These failures have led to the use of vancomycin doses higher than those approved by the Food and Drug Administration. Higher doses are being administered to achieve goal vancomycin trough concentrations of 10 to 20 microg/mL recommended by several clinical practice guidelines endorsed by the Infectious Diseases Society of America. Recent studies suggest that increased rates of nephrotoxicity are associated with aggressive vancomycin dosing. These increased rates are confounded by concomitant nephrotoxins, renal insufficiency, or changing hemodynamics. These studies also have demonstrated that vancomycin's nephrotoxicity risk is minimal in patients without risk factors for nephrotoxicity. Clinicians unwilling to dose vancomycin in accordance with clinical practice guidelines should use an alternative agent because inadequate dosing increases the likelihood of selecting heteroresistant methicillin-resistant S. aureus isolates.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.