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J. Korean Med. Sci. · Apr 2023
Evaluation of Vancomycin TDM Strategies: Prediction and Prevention of Kidney Injuries Based on Vancomycin TDM Results.
- Byungwook Kim, Sejung Hwang, Eunjeong Heo, Hyung-Sook Kim, Jongtak Jung, Eu Suk Kim, Hong Bin Kim, Kyunghoon Lee, Jeong Su Park, Junghan Song, Joon Hee Lee, Jae-Yong Chung, Kyoung-Ho Song, and Seonghae Yoon.
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
- J. Korean Med. Sci. 2023 Apr 10; 38 (14): e101e101.
AbstractThe current guidelines for therapeutic drug monitoring (TDM) of vancomycin suggest a target 24-hour area under the curve (AUC0-24) of 400 to 600 mg*h/L for serious methicillin-resistant Staphylococcus aureus 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 AUC0-24 and trough values were calculated by both one- and two-point sampling methods, and were evaluated for the predictability of AKI. Among the AUC0-24 cutoff comparisons, the threshold value of 500 mg*h/L in the two sampling methods was statistically significant (P = 0.042) when evaluated for the predictability of AKI. Analysis by an receiver operating characteristic curve estimated an AUC0-24 cutoff value of 563.45 mg*h/L as a predictor of AKI, and was proposed as the upper limit of TDM target.© 2023 The Korean Academy of Medical Sciences.
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