ArticleDrugs - real world outcomes2026
Association Between Follow-Up Therapeutic Drug Monitoring and Vancomycin-Induced Nephrotoxicity: A Claims Database Study.
Article in Drugs - real world outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundIn vancomycin treatment, follow-up therapeutic drug monitoring (TDM) within 1 week after the initial TDM is recommended in patients with dose change after the initial TDM or high risk of vancomycin-induced nephrotoxicity (VIN); however, the effectiveness of follow-up TDM implementation remains unclear. This study aimed to delineate outcomes of follow-up TDM after the initial assessment under real-world conditions in Japan and clarify its association with VIN.
methodsRetrospective data analysis was conducted using a Japanese health insurance claims database. Approval was granted by the Ethics Committee of Osaka Medical and Pharmaceutical University (protocol number: 2022-105). Adult patients who received intravenous vancomycin, excluding those without a dose change after the initial TDM and without risk of VIN between January 2020 and December 2021, were included. Follow-up TDM was defined as conducting TDM within 1 week after the initial assessment. The association between performing follow-up TDM and the occurrence of VIN was assessed in patients with dose change after the initial TDM or high risk of VIN.
resultsAmong 492 patients who underwent the initial TDM, 403 (81.9%) had follow-up TDM performed. Cox proportional hazards model analysis revealed that follow-up TDM was associated with a lower occurrence of VIN after adjustment for estimated glomerular filtration rate <30 mL/min/1.73 m
conclusionThis study found that follow-up TDM was associated with a lower occurrence of VIN, supporting guidelines recommending follow-up TDM in vancomycin therapy. Health providers should consider conducting follow-up TDM to potentially lower the occurrence of VIN, although further prospective studies are warranted to clarify its independent effect.
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