Observational studyBMC anesthesiology2015
Evaluation of a protocol for vancomycin administration in critically patients with and without kidney dysfunction.
Observational study in BMC anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Augmented Renal Clearance in Critically Ill Patients: A Systematic Review.Clinical pharmacokinetics · 2018Pooled it
- Inflammaging in Multidrug-Resistant Sepsis of Geriatric ICU Patients and Healthcare Challenges.Geriatrics (Basel, Switzerland) · 2024Review
- Multidrug-Resistant Sepsis: A Critical Healthcare Challenge.Antibiotics (Basel, Switzerland) · 2024Review
- Performance of different body weights in the Cockcroft-Gault equation in critically ill patients with and without augmented renal clearance: A multicenter cohort.Pharmacotherapy · 2023Article
- Prevalence of Augmented Renal Clearance (ARC), Utility of Augmented Renal Clearance Scoring System (ARC score) and Augmented Renal Clearance in Trauma Intensive Care Scoring System (ARCTIC score) in Predicting ARC in the Intensive Care Unit: Proactive Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Multidrug Resistance in Critically Ill Patients: An Unresolved Issue.Microorganisms · 2023Article
- Critically Ill Patients with Renal Hyperfiltration: Optimizing Antibiotic Dose.International journal of nephrology · 2023Review
- Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program.Antibiotics (Basel, Switzerland) · 2022Article
- 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
- Augmented Renal Clearance in Severe Infections-An Important Consideration in Vancomycin Dosing: A Narrative Review.Frontiers in pharmacology · 2022Review
- Review
- Population Pharmacokinetic Modeling and Dose Optimization of Vancomycin in Chinese Patients with Augmented Renal Clearance.Antibiotics (Basel, Switzerland) · 2021Article
- A higher dose of vancomycin is needed in critically ill patients with augmented renal clearance.Translational andrology and urology · 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
- A Novel Method for the Determination of Vancomycin in Serum by High-Performance Liquid Chromatography-Tandem Mass Spectrometry and Its Application in Patients with Diabetic Foot Infections.Molecules (Basel, Switzerland) · 2018Article
- Augmented Renal Clearance in Critical Illness: An Important Consideration in Drug Dosing.Pharmaceutics · 2017Review
- Review of vancomycin-induced renal toxicity: an update.Therapeutic advances in endocrinology and metabolism · 2016Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdministration of vancomycin in critically ill patients needs close regulation. While subtherapeutical vancomycin serum concentration (VSC) is associated with increased mortality, accumulation is responsible for nephrotoxicity. Our study aimed to estimate the efficacy of a vancomycin-dosing protocol in reaching appropriate serum concentration in patients with and without kidney dysfunction.
methodsThis was a retrospective study in critically ill patients treated with continuous infusion of vancomycin. Patients with creatinine clearance > 50 ml/min (Group A) were compared to those with creatinine clearance ≤ 50 ml/min (Group B).
results348 patients were enrolled (210 in Group A, 138 in Group B). At first determination, patients with kidney dysfunction (Group B) had a statistically higher percentage of vancomycin in target range, while the percentage of patients with a VSC under the range was almost equal. These percentages differed at the subsequent measurements. The number of patients with low vancomycin concentration progressively decreased, except in those with augmented renal clearance; the percentage of patients with VSC over 30 mg/L was about 28 %, irrespective of the presence or absence of kidney dysfunction. Patients who reached a subtherapeutic level at the first VSC measurement had a significant correlation with in-hospital mortality.
conclusionsOur protocol seems to allow a rapid achievement of a target VSC particularly in patients with kidney dysfunction. In order to avoid subtherapeutical VSC, our algorithm should be implemented by the estimation of the presence of an augmented renal clearance.
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