ArticleYonsei medical journal2025
Optimizing Vancomycin Area under the Concentration-Time Curve Targets in Enterococcal Bacteremia: Balancing Efficacy and Nephrotoxicity.
Article in Yonsei medical journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Bayesian Estimation of Vancomycin Exposure and Population Pharmacokinetics in Obese Patients.Antibiotics (Basel, Switzerland) · 2026Article
- Optimizing vancomycin therapy: the critical role of dosing frequency, AUC monitoring and gender: a retrospective cohort study.Frontiers in pharmacology · 2026Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeVancomycin is critical in treating enterococcal bacteremia; however, its optimal pharmacokinetic (PK)/pharmacodynamics (PD) targets remain unclear. This study evaluates the association between vancomycin PK/PD parameters and clinical outcomes in patients with enterococcal bacteremia. MATERIALS AND
methodsThis retrospective cohort study included 70 patients with enterococcal bacteremia treated with vancomycin at a university-affiliated teaching hospital. The primary and secondary outcomes were unfavorable clinical outcome (30-day mortality or persistent bacteremia) and nephrotoxicity, respectively. Vancomycin area under the concentration-time curve (AUC)/minimal inhibitory concentration (MIC) was calculated using Bayesian methods. Receiver operating curve (ROC) analysis determined AUC/MIC thresholds for predicting unfavorable clinical outcomes and nephrotoxicity. Logistic regression analysis identified risk factors for clinical outcomes.
resultsUnfavorable outcome occurred in 21 patients (30.0%), and 10 (14.3%) experienced nephrotoxicity. The ROC-derived AUC₂₄/MIC cutoff for unfavorable outcome and nephrotoxicity were AUC₂₄/MIC ≥466.0 [AUC=0.740; 95% confidence interval (CI), 0.618-0.862] and ≥643.2 (AUC=0.963; 95% CI, 0.922-1.000), respectively. Clinical success was achieved in 44.9% (22/49) of patients with an AUC₂₄/MIC <400, whereas 47.6% (10/21) experienced unfavorable outcome despite having an AUC₂₄/MIC of 400-600. Nephrotoxicity [adjusted odds ratio (aOR)=15.05; 95% CI, 2.15-105.14;
conclusionNephrotoxicity and multiple comorbidities were stronger risk factors for unfavorable outcomes than vancomycin AUC/MIC. These findings highlight the need for individualized strategies to optimize efficacy while minimizing toxicity. Further large-scale studies are warranted to refine the optimal AUC/MIC threshold.
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