ArticleTherapeutics and clinical risk management2020
Vancomycin in ICU Patients with Gram-Positive Infections: Initial Trough Levels and Mortality.
Article in Therapeutics and clinical risk management, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Prognostic Implications of Vancomycin Therapeutic Drug Monitoring for Critically Ill Stroke Patients: Evidence From a Subtype-Oriented Analysis.CNS neuroscience & therapeutics · 2026Article
- Antimicrobial dosing considerations in critically ill patients with acute kidney injury: A review.World journal of nephrology · 2025Review
- 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
- Monitoring vancomycin blood concentrations reduces mortality risk in critically ill patients: a retrospective cohort study using the MIMIC-IV database.Frontiers in pharmacology · 2024Article
- Bacterial Toxin-Triggered Release of Antibiotics from Capsosomes Protects a Fly Model from Lethal Methicillin-Resistant Staphylococcus aureus (MRSA) Infection.Advanced healthcare materials · 2022Article
- Effect of First Trough Vancomycin Concentration on the Occurrence of AKI in Critically Ill Patients: A Retrospective Study of the MIMIC-IV Database.Frontiers in medicine · 2022Article
- The impact of early target attainment of vancomycin in critically ill patients with confirmed Gram-positive infection: A retrospective cohort study.BMC infectious diseases · 2021Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundVancomycin is one of the most common therapeutic agents for treating gram-positive infections, particularly in critically ill patients. The aim of this study was to identify factors associated with initial therapeutic vancomycin trough levels and mortality in a tertiary-care intensive care unit (ICU).
methodsThis retrospective study evaluated 301 adult ICU patients admitted to King Abdulaziz Medical City in Riyadh between October 1, 2017 and December 31, 2018 with confirmed gram-positive infections and received intravenous vancomycin. Vancomycin trough levels of 15-20 mg/L for severe infections and 10-15 mg/L for less severe infections were considered therapeutic.
resultsThe patients were relatively older with a mean age of 60 (SD ±20) years. Initial vancomycin trough levels were therapeutic in 168 (55.8%). Factors associated with initial therapeutic vancomycin trough levels were female gender (adjusted odds ratio [aOR]=2.575), older age (aOR=1.024), receiving a loading dose (aOR=2.445), having bacteremia (aOR=2.061), and high platelet count (aOR=1.003). On the other hand, the increase of estimated glomerular filtration rate (eGFR) (aOR=0.993) and albumin levels (aOR=0.944) were associated with lower odds of initial therapeutic vancomycin trough levels. Factors associated with higher mortality were female gender (adjusted hazard ratio [aHR]=2.630), increased body weight (aHR=1.021), cancer (aHR=3.451), and high APACHE II score (aHR=1.068).
conclusionThe study identified several factors associated with achieving initial therapeutic vancomycin trough levels (i.e. older age, female gender, receiving a loading dose, bacteremia, high platelets count, low eGFR and albumin level). These factors should be considered in the dosing of vancomycin in critically ill patients with gram-positive infections.
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