In Outpatients Receiving Parenteral Vancomycin, Dosing Adjustments Produced by Area Under the Curve-Based and Trough-Based Monitoring Differ Only at the Extremes of the Therapeutic Trough Range. (7th January 2023)

• Record Type: Journal Article
• Authors: Shi, Yufei; Alexander, Bryan T; Avedissian, Sean; Bergman, Scott J; Cortés-Penfield, Nicolás
• Is Part Of: Open forum infectious diseases. Volume 10:Number 2(2023)
• Publication Date: 2023-01-07
• Subjects: monitoring -- nephrotoxicity -- OPAT -- therapeutic dose monitoring -- vancomycin; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac696
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Area under the curve (AUC)-based vancomycin dosing reduces nephrotoxicity but is burdensome. Reviewing 115 adults receiving ≥2 weeks of outpatient vancomycin, we found AUC-based and trough-based dose adjustments discordant only for troughs <12 or >16 mg/L. Selective versus universal outpatient AUC calculation would likely offer similar benefit with reduced workload. Abstract : Outpatient AUC- and trough-based vancomycin monitoring produced similar dose adjustment recommendations for serum troughs 12–16 mg/L but diverged at the 10–20 mg/L range. Selective versus universal AUC monitoring may similarly reduce vancomycin nephrotoxicity with substantially lower workload.