{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:41:17Z","timestamp":1791996077330,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bpspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacology Res &amp;amp; Perspec"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The recommended therapeutic target for vancomycin for serious methicillin\u2010resistant <jats:styled-content style=\"fixed-case\"><jats:italic>S. aureus<\/jats:italic><\/jats:styled-content> infections is an area under the concentration\u2013time curve (AUC) over 24\u2009h to a minimum inhibitory concentration (MIC) ratio of \u2265\u2009400. Its applicability to coagulase\u2010negative staphylococcal (CoNS) bloodstream infections is unclear. Our review aims to determine the pharmacodynamic target of vancomycin for CoNS bloodstream infections. In January 2025, MEDLINE, Embase, and PubMed were searched to identify manuscripts reporting the relationship between vancomycin drug exposure (AUC) and bactericidal activity or clinical response for CoNS. Studies of alternative drug delivery systems\/formulations, combination therapy, prophylaxis, other infections, and static in\u00a0vitro studies were excluded. Overall, six articles were included. One in\u00a0vivo study in young infants found that an AUC<jats:sub>0\u201024<\/jats:sub>\u2009\u2265\u2009300\u2009mg\/L\u00b7h and AUC<jats:sub>24<\/jats:sub>\u2009\u2265\u2009424\u2009mg\/L\u00b7h were associated with a 7.8\u2010fold and 7.3\u2010fold increased likelihood of bacteriological cure, respectively. Two studies in adults showed that an AUC<jats:sub>24<\/jats:sub>\/MIC ratio \u2265\u2009373 resulted in improved treatment success and microbiological eradication. An in\u00a0vitro model demonstrated that a vancomycin AUC<jats:sub>24<\/jats:sub>\/MIC ratio \u2265\u2009665 achieved maximal bacterial killing, while a rabbit model linked an AUC<jats:sub>24<\/jats:sub>\/MIC \u2265\u2009520 to an 80% reduction in C\u2010reactive protein. Early treatment within 24\u2009h was associated with the greatest chance of bacteriological cure. Two studies of biofilm\u2010embedded CoNS demonstrated inadequate bacterial killing at AUC<jats:sub>24<\/jats:sub>\/MIC ratios of 260 and 354. Overall, or CoNS bloodstream infections, an AUC<jats:sub>24<\/jats:sub>\u2009\u2265\u2009424\u2009mg\/L\u00b7h (median MIC 1\u2009mg\/L) or AUC<jats:sub>24<\/jats:sub>\/MIC \u2265\u2009373 improves clinical outcomes. This review highlights the need for early effective vancomycin treatment. Alternative antibiotic therapy should be considered for biofilm\u2010embedded CoNS infections.<\/jats:p>","DOI":"10.1002\/prp2.70180","type":"journal-article","created":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T15:09:02Z","timestamp":1759072142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pharmacodynamics of Vancomycin Against Coagulase\u2010Negative Staphylococci Bloodstream Infections"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9507-2497","authenticated-orcid":false,"given":"Kiera H.","family":"Harwood","sequence":"first","affiliation":[{"name":"Department of Paediatrics The University of Melbourne  Victoria Australia"},{"name":"Antimicrobials Group Murdoch Children's Research Institute  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney 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