ArticleCritical care (London, England)2014
Decreasing the time to achieve therapeutic vancomycin concentrations in critically ill patients: developing and testing of a dosing nomogram.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- A Meta-Analysis on the Performance of Cystatin C- versus Creatinine-based eGFR Equations in Predicting Vancomycin Clearance.Journal of Korean medical science · 2020Pooled it
- Augmented Renal Clearance in Critically Ill Patients: A Systematic Review.Clinical pharmacokinetics · 2018Pooled it
- Machine learning for the prediction of augmented renal clearance (ARC) in patients with sepsis in critical care units.Scientific reports · 2025Article
- Optimizing Initial Vancomycin Dosing in Hospitalized Patients Using Machine Learning Approach for Enhanced Therapeutic Outcomes: Algorithm Development and Validation Study.Journal of medical Internet research · 2025Article
- The Impact of Augmented Renal Clearance on Vancomycin Pharmacokinetics and Pharmacodynamics in Critically Ill Patients.Journal of clinical medicine · 2024Review
- Measured Creatinine Clearance: Still a Good Surrogate of Glomerular Filtration Rate in Neurocritically Ill Patients!Neurocritical care · 2023Article
- Can precision antibiotic prescribing help prevent the spread of carbapenem-resistant organisms in the hospital setting?JAC-antimicrobial resistance · 2023Review
- Development of a Predictive Dosing Nomogram to Achieve PK/PD Targets of Amikacin Initial Dose in Critically Ill Patients: A Non-Parametric Approach.Antibiotics (Basel, Switzerland) · 2023Article
- Critically Ill Patients with Renal Hyperfiltration: Optimizing Antibiotic Dose.International journal of nephrology · 2023Review
- Risk factors associated with augmented renal clearance in a mixed intensive care unit population: a retrospective study.International journal of clinical pharmacy · 2022Observational
- Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review.Clinical pharmacokinetics · 2022Review
- Predictive performance of reported vancomycin population pharmacokinetic model in patients with different renal function status, especially those with augmented renal clearance.European journal of hospital pharmacy : science and practice · 2022Article
- Prevalence and Risk Factors of Augmented Renal Clearance: A Systematic Review and Meta-Analysis.Pharmaceutics · 2022Review
- Are Antibiotics Appropriately Dosed in Critically Ill Patients with Augmented Renal Clearance? A Narrative Review.International journal of clinical practice · 2022Review
- Augmented Renal Clearance in Severe Infections-An Important Consideration in Vancomycin Dosing: A Narrative Review.Frontiers in pharmacology · 2022Review
- Vancomycin Serum Concentration after 48 h of Administration: A 3-Years Survey in an Intensive Care Unit.Antibiotics (Basel, Switzerland) · 2020Article
- What Are the Current Approaches to Optimising Antimicrobial Dosing in the Intensive Care Unit?Pharmaceutics · 2020Review
- Genetic Algorithms as a Tool for Dosing Guideline Optimization: Application to Intermittent Infusion Dosing for Vancomycin in Adults.CPT: pharmacometrics & systems pharmacology · 2020Article
- Area under the Curve-Based Dosing of Vancomycin in Critically Ill Patients Using 6-Hour Urine Creatinine Clearance Measurement.Critical care research and practice · 2020Article
- Augmented renal clearance in pediatric intensive care: are we undertreating our sickest patients?Pediatric nephrology (Berlin, Germany) · 2020Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAchievement of optimal vancomycin exposure is crucial to improve the management of patients with life-threatening infections caused by susceptible Gram-positive bacteria and is of particular concern in patients with augmented renal clearance (ARC). The aim of this study was to develop a dosing nomogram for the administration of vancomycin by continuous infusion for the first 24 hours of therapy based on the measured urinary creatinine clearance (8 h CLCR).
methodsThis single-center study included all critically ill patients treated with vancomycin over a 13-month period (group 1), in which we retrospectively assessed the correlation between vancomycin clearance and 8 h CLCR. This data was used to develop a formula for optimised drug dosing. The efficiency of this formula was prospectively evaluated in a second cohort of 25 consecutive critically ill patients (group 2). Vancomycin serum concentrations between 20 to 30 mg/L were considered adequate. ARC was defined as 8 h CLCR more than 130 ml/min/1.73 m(2).
resultsThe incidence of ARC was 36% (n = 29/79) and 40% (10/25) in group 1 (n = 79) and 2 (n = 25), respectively. The mean serum vancomycin concentration on day 1 was 21.5 (6.4) and 24.5 (5.2) mg/L, for both groups respectively. On the treatment day, vancomycin plasma clearance was 5.12 (1.9) L/h in group 1 and correlated significantly with the 8 h CLCR (r(2) = 0.66; P < 0.001). The achievement of adequate vancomycin serum concentrations in group 2 was 84% (n = 21/25) versus 51% (n = 40/79) - P < 0.005.
conclusionsThis new vancomycin nomogram enabled the achievement of adequate serum concentrations in 84% of the patients on the first day of treatment.
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