ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Vancomycin Advanced Therapeutic Drug Monitoring: Exercise in Futility or Virtuous Endeavor to Improve Drug Efficacy and Safety?
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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.
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Who cites it
17 citing papers in PubMed, 40 citations in OpenAlex.
- Promising efficacy of oral nano-silymarin formulation on prevention of vancomycin-induced nephrotoxicity: a randomized, triple-blinded, placebo-controlled clinical trial.Naunyn-Schmiedeberg's archives of pharmacology · 2026Trial
- Optimizing Vancomycin Area under the Concentration-Time Curve Targets in Enterococcal Bacteremia: Balancing Efficacy and Nephrotoxicity.Yonsei medical journal · 2025Article
- A Deep Learning-Based Approach for Prediction of Vancomycin Treatment Monitoring: Retrospective Study Among Patients With Critical Illness.JMIR formative research · 2024Article
- Analytical Validation of Aptamer-Based Serum Vancomycin Monitoring Relative to Automated Immunoassays.ACS sensors · 2024Article
- Is it time to recommend AUC-based vancomycin therapeutic drug monitoring only? A cross-sectional survey in China.Frontiers in pharmacology · 2024Article
- Review
- Optimization of Vancomycin Aptamer Sequence Length Increases the Sensitivity of Electrochemical, Aptamer-Based Sensors In Vivo.ACS sensors · 2022Article
- Metagenome Analysis Reveals a Response of the Antibiotic Resistome to Mars-like Extraterrestrial Conditions.Astrobiology · 2022Article
- Microneedle Aptamer-Based Sensors for Continuous, Real-Time Therapeutic Drug Monitoring.Analytical chemistry · 2022Article
- Approaching 65 Years: Is It Time to Consider Retirement of Vancomycin for Treating Methicillin-ResistantOpen forum infectious diseases · 2022Article
- Pharmacokinetics and pharmacodynamics of peptide antibiotics.Advanced drug delivery reviews · 2022Review
- Pharmacokinetic equations versus Bayesian guided vancomycin monitoring: Pharmacokinetic model and model-informed precision dosing trial simulations.Clinical and translational science · 2022Article
- A Systematic Review on Clinical Safety and Efficacy of Vancomycin Loading Dose in Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2022Review
- Therapeutic drug monitoring of vancomycin in neurosurgery patients, from trough concentration to area under the curve: a retrospective single center cohort study in a tertiary hospital.The Journal of international medical research · 2022Article
- Vancomycin Duration of Therapy Can Inform the Need for Area Under the Curve Monitoring.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Heaping the Pelion of Vancomycin on the Ossa of Methicillin-resistant Staphylococcus aureus: Back to Basics in Clinical Care and Guidelines.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Individualized Vancomycin Dosing with Therapeutic Drug Monitoring and Pharmacokinetic Consultation Service: A Large-Scale Retrospective Observational Study.Drug design, development and therapy · 2021Observational
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Vancomycin is commonly prescribed to hospitalized patients. Decades of pharmacokinetic/pharmacodynamic research culminated in recommendations to monitor the ratio of the area under the concentration-time curve (AUC) to the minimum inhibitory concentration in order to optimize vancomycin exposure and minimize toxicity in the revised 2020 guidelines. These guideline recommendations are based on limited data without high-quality evidence and limitations in strength. Despite considerable effort placed on vancomycin therapeutic drug monitoring (TDM), clinicians should recognize that the majority of vancomycin use is empiric. Most patients prescribed empiric vancomycin do not require it beyond a few days. For these patients, AUC determinations during the initial days of vancomycin exposure are futile. This added workload may detract from high-level patient care activities. Loading doses likely achieve AUC targets, so AUC monitoring after a loading dose is largely unnecessary for broad application. The excessive vancomycin TDM for decades has been propagated with limitations in evidence, and it should raise caution on contemporary vancomycin TDM recommendations.
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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.