Guo T, Du LY, Liu MF, Zhou XJ, Chen XR. Correlations of vancomycin trough concentration and its efficacy and toxicity in patients in the intensive care unit. World J Clin Cases 2025; 13(16): 102866 [DOI: 10.12998/wjcc.v13.i16.102866]
Corresponding Author of This Article
Xin-Ran Chen, Department of Pharmacy, The Fourth Hospital of Hebei Medical University, Hebei Key Laboratory of Clinical Pharmacy, No. 12 Jiankang Road, Chang’an District, Shijiazhuang 050011, Hebei Province, China. 48101847@hebmu.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correlations of vancomycin trough concentration and its efficacy and toxicity in patients in the intensive care unit
Teng Guo, Li-Ying Du, Ming-Feng Liu, Xia-Jin Zhou, Xin-Ran Chen
Teng Guo, Li-Ying Du, Ming-Feng Liu, Xia-Jin Zhou, Xin-Ran Chen, Department of Pharmacy, The Fourth Hospital of Hebei Medical University, Hebei Key Laboratory of Clinical Pharmacy, Shijiazhuang 050011, Hebei Province, China
Author contributions: Guo T, Du LY, Liu MF, and Chen XR performed the research; Chen XR designed the research study; Zhou XJ and Guo T completed the analysis; Guo T and Chen XR wrote and edited the manuscript; All authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Key Project Plan of Health and Medical Science Research in Hebei Provincial Health Commission, No. 20190745.
Institutional review board statement: This study was approved by the Medical Ethics Committee of The Fourth Hospital of Hebei Medical University, approval No. 2021KS031.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Ran Chen, Department of Pharmacy, The Fourth Hospital of Hebei Medical University, Hebei Key Laboratory of Clinical Pharmacy, No. 12 Jiankang Road, Chang’an District, Shijiazhuang 050011, Hebei Province, China. 48101847@hebmu.edu.cn
Received: November 4, 2024 Revised: December 24, 2024 Accepted: January 9, 2025 Published online: June 6, 2025 Processing time: 101 Days and 0 Hours
Abstract
BACKGROUND
Plasma concentration monitoring is crucial for optimizing vancomycin use, particularly in patients in the intensive care unit (ICU). However, the reference interval for vancomycin plasma concentration remains undetermined.
AIM
To evaluate the correlations of area under the curve (AUC0-24) and trough concentration (Cmin) with efficacy and nephrotoxicity in patients in the ICU.
METHODS
A total of 103 patients treated with vancomycin for methicillin-resistant Staphylococcus aureus infections were analyzed in this study. The associations of clinicodemographic characteristics (including sex, age, weight, infection sites, main etiologies of ICU cases, comorbidities, acute physiological chronic health evaluation II score, and mechanical ventilation) and pharmacokinetics (daily dose, Cmin, AUC0-24, and AUC0-24/minimum inhibitory concentration) with efficacy and nephrotoxicity of vancomycin were evaluated with univariate and multivariate logistic regression analyses. AUC0-24 was calculated using VCM-TDM software based on vancomycin population pharmacokinetics and Bayesian feedback method.
RESULTS
Cmin over 9.4 μg/mL and AUC0-24 exceeding 359.6 μg × hour/mL indicated good efficacy against infection. Cmin below 14.0 μg/mL predicted no significant nephrotoxicity.
CONCLUSION
In this study, the effective and safe concentration interval for vancomycin in patients in the ICU was Cmin 9.4-14.0 μg/mL. Close attention should be paid to adverse effects and renal function during vancomycin treatment.
Core Tip: Plasma concentration monitoring is essential for optimizing vancomycin therapy. This study investigated the relationship between clinical characteristics, pharmacokinetic parameters of vancomycin, specifically the trough concentration and area under the curve, and its efficacy and nephrotoxicity in Chinese patients in the intensive care unit to inform personalized vancomycin administration. The results showed that the effective and safe concentration interval for vancomycin for patients in the intensive care unit was a trough concentration of 9.4-14.0 μg/mL.
