Evidence map›Paper›PMID 42706573›Full record

ArticleCritical care (London, England)2026

Vancomycin optimised dosing regimens for critically ill patients receiving renal replacement therapy.

Marta Ulldemolins, Jeffrey Lipman, Xin Liu, Mohd-Hafiz Abdul-Aziz, João P Baptista, Irma Bilgrami, Laurent Bitker, Clement Boidin, Alexander Brinkmann, Vesa Cheng and 55 more

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Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

65 authors.

Marta UlldemolinsFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Jeffrey LipmanFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Xin LiuFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Mohd-Hafiz Abdul-AzizFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
João P BaptistaIntensive Care Medicine Department, Hospitais da Universidade de Coimbra (HUC), ULS Coimbra, Coimbra, Portugal.
Irma BilgramiIntensive Care Unit, Royal Darwin Hospital, Tiwi, NT, Australia.
Laurent BitkerDepartment of Intensive Care Medicine, Groupement Hospitalier Nord, Hospices Civils de Lyon, Hôpital de La Croix-Rousse, Lyon, Rhône-Alpes, France.
Clement BoidinFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Alexander BrinkmannDepartment of Anaesthesia and Critical Care Medicine, General Hospital of Heidenheim, Heidenheim, Germany.
Vesa ChengFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Gordon ChoiDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
C Louise ColeSchool of Medicine, University of Sydney, Sydney, Australia.
Jan J De WaeleDepartment of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
Renae DeansFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Glenn M EastwoodANZIC RC, Monash University, Melbourne, Australia.
Leslie EscobarFaculty of Medicine, Universidad de Chile, Santiago, Chile.
Otto R FreyDepartment of Pharmacy, General Hospital of Heidenheim, Heidenheim, Germany.
Romain GarreauLaboratoire de Biométrie Et Biologie Évolutive, Université Claude Bernard Lyon 1, UMR CNRS 5558, Lyon, France.
Sylvain GoutelleLaboratoire de Biométrie Et Biologie Évolutive, Université Claude Bernard Lyon 1, UMR CNRS 5558, Lyon, France.
Rebecca GreshamSchool of Medicine, University of Sydney, Sydney, Australia.
Maria Patricia Hernandez-MitreFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Janattul Ain JamalDepartment of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Malaysia.
Gavin M JoyntDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Salmaan KanjiDepartment of Pharmacy, The Ottawa Hospital, Ottawa, Canada.
Jan T KielsteinInstitute of Pharmacology, Toxicology and Clinical Pharmacy, Technical University Braunschweig, Brunswick, Germany.
Stefan KlugeDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christina KönigDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Vasilios P KoulourasIntensive Care Unit Department, University Hospital of Ioannina, Ioannina, Greece.
Melissa Lassig-SmithDepartment of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Pierre-Francois LaterreIntensive Care Unit, Clinique Universitaire St Luc, UCLouvain, Brussels, Belgium.
Anna LeeDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Jean-Yves LefrantUR-UM103 IMAGINE, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Universite Montpellier, Nîmes University Hospital, Montpellier, France.
Katie LeiGuy's and St Thomas' NHS Foundation Trust, London, UK.
Patricia LeungDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Mohd-Basri Mat-NorKulliyyah of Medicine, International Islamic University Malaysia, Kuantan Campus, Kuantan, Pahang, Malaysia.
Yugan MudaliarCritical Care Intensive Care Unit Services, Westmead Public/Private Hospitals, Sydney, Australia.
Marlies OstermannGuy's and St Thomas' NHS Foundation Trust, London, UK.
Sanjoy K PaulCollege of Life Sciences, University of Leicester, Leicester, UK.
Sandra L PeakeDepartment of Intensive Care Medicine, The Queen Elizabeth Hospital, Woodville, Australia.
Jordi RelloUR-UM103 IMAGINE, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Universite Montpellier, Nîmes University Hospital, Montpellier, France.
Jean-Christophe RichardDepartment of Intensive Care Medicine, Groupement Hospitalier Nord, Hospices Civils de Lyon, Hôpital de La Croix-Rousse, Lyon, Rhône-Alpes, France.
Brent RichardsIntensive Care Unit, Gold Coast University Hospital, Gold Coast, Australia.
Darren M RobertsFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Michael S RobertsTherapeutics Research Centre, Faculty of Medicine, UQCCR and Frazer Institute, The University of Queensland, Brisbane, Australia.
Anka C RoehrDepartment of Pharmacy, General Hospital of Heidenheim, Heidenheim, Germany.
Claire RogerUR-UM103 IMAGINE, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Universite Montpellier, Nîmes University Hospital, Montpellier, France.
Leonardo SeoaneFaculty of Medicine, The University of Queensland, New Orleans, USA.
Kiran ShekarFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Mahipal SinnollareddyTherapeutics Research Centre, Faculty of Medicine, UQCCR and Frazer Institute, The University of Queensland, Brisbane, Australia.
Eduardo SousaIntensive Care Medicine Department, Hospitais da Universidade de Coimbra (HUC), ULS Coimbra, Coimbra, Portugal.
Anna SpringIntensive Care Unit, Naval and Veterans Hospital of Athens, Athens, Greece.
Therese StarrDepartment of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Dianne StephensIntensive Care Unit, Royal Darwin Hospital, Tiwi, NT, Australia.
Fabio Silvio TacconeDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Jane ThomasIntensive Care Unit, Royal Darwin Hospital, Tiwi, NT, Australia.
John TurnidgeSchool of Biological Sciences, University of Adelaide, Adelaide, Australia.
Miia ValkonenIntensive Care Medicine, Department of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Steven C WallisFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia.
Tricia WilliamsDepartment of Intensive Care Medicine, The Queen Elizabeth Hospital, Woodville, Australia.
Xavier WitteboleIntensive Care Unit, Clinique Universitaire St Luc, UCLouvain, Brussels, Belgium.
Daniel F B WrightSchool of Clinical Medicine, Faculty of Medicine and Health, St Vincent's Healthcare Clinical Campus, University of New South Wales (UNSW), Sydney, Australia.
Xanthi T ZikouIntensive Care Unit Department, Army Share Fund Hospital Athens, Athens, Greece.
Jason A RobertsFaculty of Health, Medicine, and Behavioural Sciences (HMBS), The Frazer Institute, The University of Queensland, Brisbane, Australia. j.roberts@uq.edu.au.
SMARRT Study Collaborators
European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP) and the ESCMID PK/PD of Anti-Infectives Study Group (EPASG)

Funding

National Health and Medical Research Council APP1044941Research Grants Council of the Hong Kong Special Administrative Region, China CUHK 14106614
6 · The paper itself

Abstract

backgroundOptimal dosing of vancomycin in critically ill patients receiving renal replacement therapy (RRT) is uncertain due to high pharmacokinetic variability. We aimed to develop individualised vancomycin dosing recommendations that optimise efficacy while minimising toxicity.

methodsProspective, international, pharmacokinetic study enrolling critically ill patients treated with vancomycin and various RRT modalities. A population pharmacokinetic model was developed, externally validated and applied to perform Monte Carlo dosing simulations. We calculated the probability of each dosing regimen to achieve the efficacy target against methicillin-resistant Staphylococcus aureus (ratio of the area under the concentration-time curve to the minimum inhibitory concentration (AUC

resultsWe enrolled 65 critically ill patients from 6 countries receiving continuous RRT (50.8%) or sustained low-efficiency dialysis (49.2%). The model was developed using 1318 pre- and post-filter plasma and effluent concentrations and validated with a new dataset (19 critically ill patients, 124 pre-filter plasma concentrations), with 47.4% patients concomitantly treated with extracorporeal membrane oxygenation. Predictive performance was high (median prediction error =-13.4%). Simulations showed that dosing requirements were dependent on actual body weight and RRT intensity and duration (p < 0.05). An optimised dosing nomogram was subsequently developed considering these clinical characteristics.

conclusionsActual body weight and RRT intensity and duration are the main determinants of vancomycin dosing requirements in critically ill patients treated with RRT. Efficacious, non-toxic dosing may be guided by the optimised nomogram.

Indexed as

Renal Replacement TherapyVancomycinAgedAnti-Bacterial AgentsCritical IllnessDose-Response Relationship, DrugFemaleHumansMaleMethicillin-Resistant Staphylococcus aureusMicrobial Sensitivity TestsMiddle AgedMonte Carlo MethodProspective StudiesAnti-Bacterial AgentsVancomycinActual body weightDosing nomogramIntensityRenal replacement therapyVancomycin

Identifiers

PMID42706573
PMCPMC13551861

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Registered trials

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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.