ArticleFrontiers in pharmacology2024
Monitoring vancomycin blood concentrations reduces mortality risk in critically ill patients: a retrospective cohort study using the MIMIC-IV database.
Article in Frontiers in pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- PK/PD study of vancomycin in enterococcal infections: efficacy and safety assessment under the guidance of TDM.Microbiology spectrum · 2026Observational
- Guideline-informed vancomycin therapeutic drug monitoring indications in an adult intensive care unit: a retrospective descriptive study.BMC anesthesiology · 2026Article
- Vancomycin therapeutic drug monitoring is associated with reduced toxicity in ICU patients: a MIMIC-IV retrospective study.Scientific reports · 2026Article
- Prognostic Implications of Vancomycin Therapeutic Drug Monitoring for Critically Ill Stroke Patients: Evidence From a Subtype-Oriented Analysis.CNS neuroscience & therapeutics · 2026Article
- Exploring the inhibition mechanisms of momordin Ic on S. aureus serine/threonine phosphatase (Stp1) using theoretical and experimental approaches.Scientific reports · 2025Article
- 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
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7 authors.
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Abstract
Background: The incidence and mortality of severe Gram-positive cocci infections are particularly high in intensive care units (ICUs). Vancomycin remains the treatment of choice for severe infections caused by Gram-positive cocci, particularly methicillin-resistant Methods: Data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database for a retrospective cohort analysis of critically ill patients receiving intravenous vancomycin treatment. The primary outcome was the 28 day mortality rate. The propensity score matching (PSM) method was used to match the baseline characteristics between patients in the TDM group and the non-TDM group. The relationship between 28 day mortality and vancomycin TDM in the critically ill cohort was evaluated using Cox proportional hazards regression analysis and Kaplan-Meier survival curves. Validation of the primary outcomes was conducted by comparing the PSM model and the Cox proportional hazards regression model. The robustness of the conclusion was subsequently verified by subgroup and sensitivity analyses. Results: Data for 18,056 critically ill patients who met the study criteria were collected from the MIMIC-IV database. Of these, 7,451 patients had at least one record of vancomycin blood concentration monitoring, which we defined as the TDM group. The TDM group exhibited a 28 day mortality rate of 25.7% (1,912/7,451) compared to 16.2% in the non-TDM group (1,723/10,605). After PSM, 4,264 patients were included in each of the TDM and non-TDM groups, with a 28 day mortality rate of 20.0% (1,022/4,264) in the TDM group and 26.4% (1,126/4,264) in the non-TDM group. Multivariate Cox proportional hazards analysis revealed a significantly lower 28 day mortality risk in the TDM group when compared to the non-TDM group (adjusted hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.79, 0.93; Conclusion: This cohort study showed that monitoring vancomycin blood concentrations is associated with a significantly lower 28 day mortality rate in critically ill patients, highlighting the importance of routinely performing vancomycin TDM in these patients.
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