Trial reportAntimicrobial agents and chemotherapy2018
Prospective Trial on the Use of Trough Concentration versus Area under the Curve To Determine Therapeutic Vancomycin Dosing.
Trial report in Antimicrobial agents and chemotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 154 papers, 5 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
154 citing papers in PubMed, 5 syntheses or guidelines pooled it, 349 citations in OpenAlex.
- Evaluating the Nephrotoxicity of Area-under-the-Curve-Based Dosing of Vancomycin with Concomitant Antipseudomonal Beta-Lactam Antibiotics: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Vancomycin area under the curve versus trough only guided dosing and the risk of acute kidney injury: Systematic review and meta-analysis.Pharmacotherapy · 2022Pooled it
- Dose optimization of β-lactams antibiotics in pediatrics and adults: A systematic review.Frontiers in pharmacology · 2022Pooled 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
- Vancomycin Area Under the Curve and Acute Kidney Injury: A Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- Big Data Bayesian Truths: No Vancomycin Trough Concentration Target Is Sufficiently Precise for Safety or Efficacy.Open forum infectious diseases · 2025Trial
- Achievement of therapeutic antibiotic exposures using Bayesian dosing software in critically unwell children and adults with sepsis.Intensive care medicine · 2024Trial
- Trial
- Population Pharmacokinetics of Vancomycin in Critically Ill Adult Patients Receiving Extracorporeal Membrane Oxygenation (an ASAP ECMO Study).Antimicrobial agents and chemotherapy · 2022Trial
- Trial
- Clinical and Pharmacokinetic Outcomes of Peak-Trough-Based Versus Trough-Based Vancomycin Therapeutic Drug Monitoring Approaches: A Pragmatic Randomized Controlled Trial.European journal of drug metabolism and pharmacokinetics · 2019Trial
- Multisite Analysis of Vancomycin Concentration Predictions in a Bayesian Software in Adult and Pediatric Patients With and Without Acute Kidney Injury.Pharmacotherapy · 2026Article
- Practical dose ranges supporting target vancomycin exposure with AUC-guided dosing in overweight and obese patients: A multicentre retrospective study.British journal of clinical pharmacology · 2026Article
- Bayesian-Estimated Vancomycin AUC24 as a Near-Term Renal Risk Signal after Therapeutic Drug Monitoring: A Multicenter Cohort Study.Journal of clinical pharmacology · 2026Article
- A qualitative process evaluation of a clinical trial on bedside model-informed precision dosing of vancomycin in critically ill children.International journal of clinical pharmacy · 2026Article
- Real-World Comparison of Trough- and Online-Bayesian-Calculator-Derived AUCPharmaceuticals (Basel, Switzerland) · 2026Article
- Predictive performance of an antibiotic precision dosing software program in critically ill adults with infection.The Journal of antimicrobial chemotherapy · 2026Article
- Dual therapeutic interventions to optimize vancomycin exposure and reduce nephrotoxicity: a cohort study from a single center.BMC nephrology · 2026Article
- Bayesian Estimation of Vancomycin Exposure and Population Pharmacokinetics in Obese Patients.Antibiotics (Basel, Switzerland) · 2026Article
- Vancomycin Pharmacokinetics in Obese Patients: Insights from Bayesian Modeling.European journal of drug metabolism and pharmacokinetics · 2026Article
94 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
We hypothesized that dosing vancomycin to achieve trough concentrations of >15 mg/liter overdoses many adults compared to area under the concentration-time curve (AUC)-guided dosing. We conducted a 3-year, prospective study of vancomycin dosing, plasma concentrations, and outcomes. In year 1, nonstudy clinicians targeted trough concentrations of 10 to 20 mg/liter (infection dependent) and controlled dosing. In years 2 and 3, the study team controlled vancomycin dosing with BestDose Bayesian software to achieve a daily, steady-state AUC/MIC ratio of ≥400, with a maximum AUC value of 800 mg · h/liter, regardless of trough concentration. For Bayesian estimation of AUCs, we used trough samples in years 1 and 2 and optimally timed samples in year 3. We enrolled 252 adults who were ≥18 years old with ≥1 available vancomycin concentration. Only 19% of all trough concentrations were therapeutic versus 70% of AUCs (
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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.