Observational studyRevista Brasileira de terapia intensiva
Currently used dosage regimens of vancomycin fail to achieve therapeutic levels in approximately 40% of intensive care unit patients.
Observational study in Revista Brasileira de terapia intensiva. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Genetic and nongenetic factors affecting vancomycin population pharmacokinetics and pharmacodynamics: A systematic review.Indian journal of pharmacology · 2026Pooled it
- The monitoring of vancomycin: a systematic review and meta-analyses of area under the concentration-time curve-guided dosing and trough-guided dosing.BMC infectious diseases · 2021Pooled it
- Association between vancomycin therapeutic drug monitoring and improved clinical outcomes in critically ill patients receiving renal replacement therapy: a retrospective cohort study.Frontiers in pharmacology · 2025Article
- Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review.Antibiotics (Basel, Switzerland) · 2024Review
- Monitoring vancomycin blood concentrations reduces mortality risk in critically ill patients: a retrospective cohort study using the MIMIC-IV database.Frontiers in pharmacology · 2024Article
- Review
- Vancomycin dosing and therapeutic drug monitoring practices: guidelines versus real-life.International journal of clinical pharmacy · 2021Article
- Vancomycin in ICU Patients with Gram-Positive Infections: Initial Trough Levels and Mortality.Therapeutics and clinical risk management · 2020Article
- Vancomycin is commonly under-dosed in critically ill children and neonates.British journal of clinical pharmacology · 2019Article
- Development of a Population Pharmacokinetic Model of Vancomycin and its Application in Chinese Geriatric Patients with Pulmonary Infections.European journal of drug metabolism and pharmacokinetics · 2019Article
- Article
- Does vancomycin administered at an empirical dose ensure coverage of pediatric patients against gram-positive pathogens?Revista Brasileira de terapia intensivaObservational
- The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries.Dose-response : a publication of International Hormesis SocietyArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objective: This study aimed to assess whether currently used dosages of vancomycin for treatment of serious gram-positive bacterial infections in intensive care unit patients provided initial therapeutic vancomycin trough levels and to examine possible factors associated with the presence of adequate initial vancomycin trough levels in these patients.
methods: A prospective descriptive study with convenience sampling was performed. Nursing note and medical record data were collected from September 2013 to July 2014 for patients who met inclusion criteria. Eighty-three patients were included. Initial vancomycin trough levels were obtained immediately before vancomycin fourth dose. Acute kidney injury was defined as an increase of at least 0.3mg/dL in serum creatinine within 48 hours.
results: Considering vancomycin trough levels recommended for serious gram-positive infection treatment (15 - 20µg/mL), patients were categorized as presenting with low, adequate, and high vancomycin trough levels (35 [42.2%], 18 [21.7%], and 30 [36.1%] patients, respectively). Acute kidney injury patients had significantly greater vancomycin trough levels (p = 0.0055, with significance for a trend, p = 0.0023).
conclusion: Surprisingly, more than 40% of the patients did not reach an effective initial vancomycin trough level. Studies on pharmacokinetic and dosage regimens of vancomycin in intensive care unit patients are necessary to circumvent this high proportion of failures to obtain adequate initial vancomycin trough levels. Vancomycin use without trough serum level monitoring in critically ill patients should be discouraged.
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