Evaluation of Vancomycin TDM Strategies: Prediction and Prevention of Kidney Injuries Based on Vancomycin TDM Results

• Published in: Journal of Korean medical science Vol. 38; no. 14; p. e101
• Main Authors: Kim, Byungwook, Hwang, Sejung, Heo, Eunjeong, Kim, Hyung-Sook, Jung, Jongtak, Kim, Eu Suk, Kim, Hong Bin, Lee, Kyunghoon, Park, Jeong Su, Song, Junghan, Lee, Joon Hee, Chung, Jae-Yong, Song, Kyoung-Ho, Yoon, Seonghae
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 10-04-2023; 대한의학회
• Subjects: Acute Kidney Injury - diagnosis; Acute Kidney Injury - prevention & control; Anti-Bacterial Agents - therapeutic use; Area Under Curve; Brief Communication; Drug Monitoring - methods; Humans; Kidney; Methicillin-Resistant Staphylococcus aureus; Retrospective Studies; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - prevention & control; Vancomycin - therapeutic use; 의학일반; Acute Kidney Injury; Vancomycin; Pharmacokinetics; Therapeutic Drug Monitoring
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2023.38.e101

The current guidelines for therapeutic drug monitoring (TDM) of vancomycin suggest a target 24-hour area under the curve (AUC
) of 400 to 600 mg*h/L for serious methicillin-resistant
infections. In this study, the predictabilities of acute kidney injury (AKI) of various TDM target parameters, target levels, and sampling methods were evaluated in patients who underwent TDM from January 2020 to December 2020. The AUC
and trough values were calculated by both one- and two-point sampling methods, and were evaluated for the predictability of AKI. Among the AUC
cutoff comparisons, the threshold value of 500 mg*h/L in the two sampling methods was statistically significant (
= 0.042) when evaluated for the predictability of AKI. Analysis by an receiver operating characteristic curve estimated an AUC
cutoff value of 563.45 mg*h/L as a predictor of AKI, and was proposed as the upper limit of TDM target.