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A multicentric, randomized, controlled clinical trial to study the impact of bedside model-informed precision dosing of vancomycin in critically ill children-BENEFICIAL trial.
Trials
October 2024
Department of Pediatrics, Pediatric Infectious Diseases, Specialized Pediatric Service, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Article Synopsis
- Vancomycin is an antibiotic used for serious Gram-positive infections in children, and its effectiveness depends on a specific dosing measurement known as the AUC/MIC ratio.
- The study compares a new model-informed precision dosing (MIPD) method with standard care in 14 pediatric clinical settings to see if MIPD improves dosing accuracy and reduces potential kidney damage.
- Key outcomes include the rate of patients achieving the target AUC/MIC within the first few days of treatment and monitoring the occurrence of acute kidney injury during this period.
Automated calculation and reporting of vancomycin area under the concentration-time curve: a simplified single-trough concentration-based equation approach.
Antimicrob Agents Chemother
October 2024
Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
Article Synopsis
- - Vancomycin is an important antibiotic that requires careful monitoring to ensure its effectiveness against Gram-positive bacterial infections, with recent guidelines recommending AUC (area under the curve) based monitoring for better therapeutic outcomes.
- - Researchers developed a new simplified equation, called SSTA, which estimates AUC using steady-state trough concentration and other patient factors based on data from over 1,000 TDM records from hospitalized patients.
- - The SSTA model was validated against data from other hospitals and demonstrated competitive accuracy in predicting AUC, indicating it could serve as a useful tool for monitoring vancomycin therapy effectively and easily.
Is it time to recommend AUC-based vancomycin therapeutic drug monitoring only? A cross-sectional survey in China.
Front Pharmacol
July 2024
Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Background: The latest published therapeutic drug monitoring (TDM) guidelines for vancomycin recommend changing trough-based monitoring to area under the concentration-to-time curve (AUC)-based monitoring. This study aimed to evaluate the implementation status and perceptions of vancomycin AUC-based TDM in China and to determine the challenges in performing AUC-based TDM.
Methods: A nationwide cross-sectional survey was conducted in China using an online questionnaire.
Determination of a vancomycin nephrotoxicity threshold and assessment of target attainment in hematology patients.
Pharmacol Res Perspect
August 2024
UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
An area-under-the-curve (AUC)-based approach is recommended to guide vancomycin therapeutic drug monitoring (TDM), yet trough concentrations are still commonly used despite associated risks. A definitive toxicity target is lacking, which is important for hematology patients who have a higher risk of nephrotoxicity. The aims were to (1) assess the impact of trough-based TDM on acute kidney injury (AKI) incidence, (2) establish a vancomycin nephrotoxicity threshold, and (3) evaluate the proportion of hematology patients achieving vancomycin therapeutic targets.
View Article and Find Full Text PDFA Multicenter, Retrospective Outcome Analysis of Vancomycin Area Under the Curve Versus Trough-Based Dosing Strategies in Patients With Burn OR Inhalational Injuries (MONITOR).
J Burn Care Res
November 2024
Department of Pharmacy, Regional One Health, Memphis, TN 38103, USA.
Vancomycin is a glycopeptide antibiotic that requires close therapeutic monitoring. Prolonged exposure to elevated concentrations increases risk for serious adverse effects such as nephrotoxicity. However, subtherapeutic concentrations may lead to bacterial resistance and clinical failure or death.
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