{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:13:06Z","timestamp":1778659986247,"version":"3.51.4"},"reference-count":76,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":63,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81801189"],"award-info":[{"award-number":["81801189"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the \u201cYing Cai Tuo Ju\u201d Program at the First Affiliated Hospital of Shantou University Medical College","award":["YCTJ-2022-03"],"award-info":[{"award-number":["YCTJ-2022-03"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-42395-1","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T19:53:11Z","timestamp":1773258791000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vancomycin therapeutic drug monitoring is associated with reduced toxicity in ICU patients: a MIMIC-IV retrospective study"],"prefix":"10.1038","volume":"16","author":[{"given":"Jia","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuzhu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuomin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"issue":"3","key":"42395_CR1","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/SMJ.0b013e3181647037","volume":"101","author":"DP Levine","year":"2008","unstructured":"Levine, D. P. Vancomycin: understanding its past and preserving its future. South. Med. J. 101 (3), 284\u2013291. https:\/\/doi.org\/10.1097\/SMJ.0b013e3181647037 (2008). PMID: 18364659.","journal-title":"South. Med. J."},{"key":"42395_CR2","doi-asserted-by":"publisher","unstructured":"Rybak, M. et al. Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am. J. Health Syst. Pharm. 66(1), 82\u201398. https:\/\/doi.org\/10.2146\/ajhp080434 (2009). Erratum in: Am J Health Syst Pharm. 2009;66(10):887. PMID: 19106348.","DOI":"10.2146\/ajhp080434"},{"issue":"6","key":"42395_CR3","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1086\/501641","volume":"20","author":"M. A. Abramson","year":"1999","unstructured":"Abramson, M. A. & Sexton, D. J. Nosocomial methicillin-resistant and methicillin-susceptible Staphylococcus aureus primary bacteremia: at what costs? Infect. Control Hosp. Epidemiol. 20(6), 408\u2013411. (1999). PMID: 10395142. https:\/\/doi.org\/10.1086\/501641","journal-title":"Infect. Control Hosp. Epidemiol."},{"issue":"1","key":"42395_CR4","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1086\/345476","volume":"36","author":"SE Cosgrove","year":"2003","unstructured":"Cosgrove, S. E. et al. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin. Infect. Dis. 36 (1), 53\u201359. https:\/\/doi.org\/10.1086\/345476 (2003). Epub 2002 Dec 13. PMID: 12491202.","journal-title":"Clin. Infect. Dis."},{"issue":"5","key":"42395_CR5","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1086\/367653","volume":"36","author":"JJ Engemann","year":"2003","unstructured":"Engemann, J. J. et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin. Infect. Dis. 36 (5), 592\u2013598. https:\/\/doi.org\/10.1086\/367653 (2003). Epub 2003 Feb 7. PMID: 12594640.","journal-title":"Clin. Infect. Dis."},{"issue":"2","key":"42395_CR6","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1001\/archinte.158.2.182","volume":"158","author":"S. Harbarth","year":"1998","unstructured":"Harbarth, S., Rutschmann, O., Sudre, P. & Pittet, D. Impact of methicillin resistance on the outcome of patients with bacteremia caused by Staphylococcus aureus. Arch. Intern. Med. 158(2), 182\u2013189 (1998). https:\/\/doi.org\/10.1001\/archinte.158.2.182","journal-title":"Arch. Intern. Med."},{"issue":"15","key":"42395_CR7","doi-asserted-by":"publisher","first-page":"1756","DOI":"10.1001\/archinte.165.15.1756","volume":"165","author":"G. A. Noskin","year":"2005","unstructured":"Noskin, G. A. et al. The burden of Staphylococcus aureus infections on hospitals in the United States: an analysis of the 2000 and 2001 Nationwide Inpatient Sample Database. Arch. Intern. Med. 165 (15), 1756\u20131761. (2005). https:\/\/doi.org\/10.1001\/archinte.165.15.1756","journal-title":"Arch. Intern. Med."},{"key":"42395_CR8","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1128\/AAC.36.6.1204","volume":"36","author":"MJ Rybak","year":"1992","unstructured":"Rybak, M. J., Bailey, E. M. & Warbasse, L. H. Absence of \u2018\u2018red man syndrome\u2019\u2019 in patients being treated with vancomycin or high-dose teicoplanin. Antimicrob. Agents Chemother. 36, 1204\u20131207 (1992).","journal-title":"Antimicrob. Agents Chemother."},{"key":"42395_CR9","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1001\/archinte.1988.00380100037008","volume":"148","author":"MM Bergman","year":"1988","unstructured":"Bergman, M. M., Glew, R. H. & Ebert, T. H. Acute interstitial nephritis associated with vancomycin therapy. Arch. Intern. Med. 148, 2139\u20132140 (1988).","journal-title":"Arch. Intern. Med."},{"key":"42395_CR10","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1016\/0002-9343(87)90947-8","volume":"83","author":"MA Cimino","year":"1987","unstructured":"Cimino, M. A., Rotstein, C., Slaughter, R. L. & Emrich, L. J. Relationship of serum antibiotic concentrations to nephrotoxicity in cancer patients receiving concurrent aminoglycoside and vancomycin therapy. Am. J. Med. 83, 1091\u20131097 (1987).","journal-title":"Am. J. Med."},{"key":"42395_CR11","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1093\/jac\/25.4.679","volume":"25","author":"MJ Rybak","year":"1990","unstructured":"Rybak, M. J., Albrecht, L. M., Boike, S. C. & Chandrasekar, P. H. Neph rotoxicity of vancomycin, alone and with an aminoglycoside. J. Antimicrob. Chemother. 25, 679\u2013687 (1990).","journal-title":"J. Antimicrob. Chemother."},{"key":"42395_CR12","doi-asserted-by":"publisher","first-page":"458","DOI":"10.7326\/0003-4819-95-4-458","volume":"95","author":"PG Traber","year":"1981","unstructured":"Traber, P. G. & Levine, D. P. Vancomycin ototoxicity in patient with normal renal function. Ann. Intern. Med. 95, 458\u2013460 (1981).","journal-title":"Ann. Intern. Med."},{"issue":"2","key":"42395_CR13","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1128\/AAC.01568-12","volume":"57","author":"SJ van Hal","year":"2013","unstructured":"van Hal, S. J., Paterson, D. L. & Lodise, T. P. Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter. Antimicrob. Agents Chemother. 57 (2), 734\u2013744. https:\/\/doi.org\/10.1128\/AAC.01568-12 (2013). Epub 2012 Nov 19. PMID: 23165462; PMCID: PMC3553731.","journal-title":"Antimicrob. Agents Chemother."},{"issue":"12","key":"42395_CR14","doi-asserted-by":"publisher","first-page":"2132","DOI":"10.2215\/CJN.05920616","volume":"11","author":"A Sinha Ray","year":"2016","unstructured":"Sinha Ray, A., Haikal, A., Hammoud, K. A. & Yu, A. S. L. Vancomycin and the risk of AKI: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 11 (12), 2132\u20132140. https:\/\/doi.org\/10.2215\/CJN.05920616 (2016). Epub 2016 Nov 28. PMID: 27895134; PMCID: PMC5142072.","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"42395_CR15","doi-asserted-by":"publisher","unstructured":"Khwaja, A. KDIGO clinical practice guidelines for acute kidney injury. Nephron. Clin. Pract. 120(4), c179\u2013c184. https:\/\/doi.org\/10.1159\/000339789 (2012). Epub 2012 Aug 7. PMID: 22890468.","DOI":"10.1159\/000339789"},{"issue":"4","key":"42395_CR16","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1093\/clinids\/18.4.544","volume":"18","author":"RC Moellering Jr","year":"1994","unstructured":"Moellering, R. C. Jr. Monitoring serum vancomycin levels: climbing the mountain because it is there? Clin. Infect. Dis. 18 (4), 544\u2013546. https:\/\/doi.org\/10.1093\/clinids\/18.4.544 (1994). Erratum in: Clin Infect Dis 1994;19(2):379. PMID: 8038307.","journal-title":"Clin. Infect. Dis."},{"issue":"5","key":"42395_CR17","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1592\/phco.23.5.643.32199","volume":"23","author":"W. Darko","year":"2003","unstructured":"Darko, W., Medicis, J. J., Smith, A., Guharoy, R. & Lehmann, D. E. Mississippi mud no more: cost-effectiveness of pharmacokinetic dosage adjustment of vancomycin to prevent nephrotoxicity. Pharmacotherapy 23 (5), 643\u2013650. (2003). https:\/\/doi.org\/10.1592\/phco.23.5.643.32199","journal-title":"Pharmacotherapy"},{"key":"42395_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41597-022-01899-x","volume":"10","author":"AEW Johnson","year":"2023","unstructured":"Johnson, A. E. W. et al. MIMIC-IV, a freely accessible electronic health record dataset. Sci. Data. 10, 1. https:\/\/doi.org\/10.1038\/s41597-022-01899-x (2023).","journal-title":"Sci. Data"},{"key":"42395_CR19","doi-asserted-by":"publisher","first-page":"R31","DOI":"10.1186\/cc5713","volume":"11","author":"RL Mehta","year":"2007","unstructured":"Mehta, R. L. et al. Acute Kidney Injury Network. Acute kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit. Care. 11, R31 (2007).","journal-title":"Crit. Care"},{"key":"42395_CR20","doi-asserted-by":"publisher","unstructured":"Rybak, M. J. et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Am. J. Health Syst. Pharm. 77(11), 835\u2013864. https:\/\/doi.org\/10.1093\/ajhp\/zxaa036. (2020) PMID: 32191793.","DOI":"10.1093\/ajhp\/zxaa036"},{"key":"42395_CR21","unstructured":"National Cancer Institute Common Terminology Criteria for Adverse Events. (CTCAE) Version 5.0. [(accessed on 19 November 2024)];2017 Available online: https:\/\/dctd.cancer.gov\/research\/ctep-trials\/for-sites\/adverse-events\/ctcae-v5-5x7.pdf"},{"issue":"1","key":"42395_CR22","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1002\/jcph.2363","volume":"64","author":"JJ Yang","year":"2024","unstructured":"Yang, J. J. et al. The influence of a therapeutic drug monitoring service on vancomycin-associated nephrotoxicity. J. Clin. Pharmacol. 64 (1), 19\u201329. https:\/\/doi.org\/10.1002\/jcph.2363 (2024). Epub 2023 Oct 25. PMID: 37779493.","journal-title":"J. Clin. Pharmacol."},{"issue":"10","key":"42395_CR23","doi-asserted-by":"publisher","first-page":"e77169","DOI":"10.1371\/journal.pone.0077169","volume":"8","author":"ZK Ye","year":"2013","unstructured":"Ye, Z. K., Tang, H. L. & Zhai, S. D. Benefits of therapeutic drug monitoring of vancomycin: a systematic review and meta-analysis. PLoS One. 8 (10), e77169. https:\/\/doi.org\/10.1371\/journal.pone.0077169 (2013). PMID: 24204764; PMCID: PMC3799644.","journal-title":"PLoS One"},{"issue":"4","key":"42395_CR24","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1128\/AAC.01602-07","volume":"52","author":"TP Lodise","year":"2008","unstructured":"Lodise, T. P., Lomaestro, B., Graves, J. & Drusano, G. L. Larger vancomycin doses (at least four grams per day) are associated with an increased incidence of nephrotoxicity. Antimicrob. Agents Chemother. 52 (4), 1330\u20131336. https:\/\/doi.org\/10.1128\/AAC.01602-07 (2008). Epub 2008 Jan 28. PMID: 18227177; PMCID: PMC2292536.","journal-title":"Antimicrob. Agents Chemother."},{"key":"42395_CR25","doi-asserted-by":"publisher","unstructured":"Welty, T. E. & Copa, A. K. Impact of vancomycin therapeutic drug monitoring on patient care. Ann Pharmacother. 28(12), 1335\u20131339. https:\/\/doi.org\/10.1177\/106002809402801201 (1994). PMID: 7696720.","DOI":"10.1177\/106002809402801201"},{"key":"42395_CR26","doi-asserted-by":"publisher","unstructured":"Iwamoto, T., Kagawa, Y. & Kojima, M. Clinical efficacy of therapeutic drug monitoring in patients receiving vancomycin. Biol. Pharm. Bull. 26(6), 876\u2013879. https:\/\/doi.org\/10.1248\/bpb.26.876 (2003). PMID: 12808304.","DOI":"10.1248\/bpb.26.876"},{"key":"42395_CR27","doi-asserted-by":"publisher","first-page":"1458600","DOI":"10.3389\/fphar.2024.1458600","volume":"15","author":"H Peng","year":"2024","unstructured":"Peng, H. et al. Monitoring vancomycin blood concentrations reduces mortality risk in critically ill patients: a retrospective cohort study using the MIMIC-IV database. Front. Pharmacol. 15, 1458600. https:\/\/doi.org\/10.3389\/fphar.2024.1458600 (2024). PMID: 39611174; PMCID: PMC11602295.","journal-title":"Front. Pharmacol."},{"key":"42395_CR28","unstructured":"LiverTox. Clinical and research information on drug-induced liver injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012. PMID: 31643176."},{"issue":"1","key":"42395_CR29","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.jaip.2023.09.011","volume":"12","author":"BA Asif","year":"2024","unstructured":"Asif, B. A. et al. Vancomycin-induced liver injury, DRESS, and HLA-A\u221732:01. J. Allergy Clin. Immunol. Pract. 12 (1), 168\u2013174e2 (2024). Epub 2023 Sep 20. PMID: 37739311; PMCID: PMC10885131.","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"42395_CR30","doi-asserted-by":"publisher","first-page":"1439073","DOI":"10.1155\/2018\/1439073","volume":"2018","author":"E Littlehales","year":"2018","unstructured":"Littlehales, E., Murray, O. & Dunsmuir, R. Vancomycin-Induced DRESS Syndrome: an important concern in orthopedic surgery. Case Rep. Orthop. 2018, 1439073. https:\/\/doi.org\/10.1155\/2018\/1439073 (2018). PMID: 30034896; PMCID: PMC6035812.","journal-title":"Case Rep. Orthop."},{"issue":"6","key":"42395_CR31","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1016\/j.anai.2016.03.030","volume":"116","author":"JS Minhas","year":"2016","unstructured":"Minhas, J. S., Wickner, P. G., Long, A. A., Banerji, A. & Blumenthal, K. G. Immune-mediated reactions to vancomycin: a systematic case review and analysis. Ann. Allergy Asthma Immunol. 116 (6), 544\u2013553. https:\/\/doi.org\/10.1016\/j.anai.2016.03.030 (2016). Epub 2016 May 4. PMID: 27156746; PMCID: PMC4946960.","journal-title":"Ann. Allergy Asthma Immunol."},{"issue":"20","key":"42395_CR32","doi-asserted-by":"publisher","first-page":"3035","DOI":"10.2169\/internalmedicine.55.6902","volume":"55","author":"J Yamanouchi","year":"2016","unstructured":"Yamanouchi, J. et al. Vancomycin-induced immune thrombocytopenia proven by the detection of vancomycin-dependent anti-platelet antibody with flow cytometry. Intern. Med. 55 (20), 3035\u20133038. https:\/\/doi.org\/10.2169\/internalmedicine.55.6902 (2016). Epub 2016 Oct 15. PMID: 27746445; PMCID: PMC5109575.","journal-title":"Intern. Med."},{"issue":"2","key":"42395_CR33","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3390\/hematolrep15020028","volume":"15","author":"S Shah","year":"2023","unstructured":"Shah, S., Sweeney, R., Rai, M. & Shah, D. A case of vancomycin-induced severe immune thrombocytopenia. Hematol. Rep. 15 (2), 283\u2013289. https:\/\/doi.org\/10.3390\/hematolrep15020028 (2023). PMID: 37218820; PMCID: PMC10204526.","journal-title":"Hematol. Rep."},{"issue":"2","key":"42395_CR34","doi-asserted-by":"publisher","first-page":"e232302","DOI":"10.1136\/bcr-2019-232302","volume":"13","author":"K Yuan","year":"2020","unstructured":"Yuan, K., Awan, K. S. & Long, J. Vancomycin-induced drug rash with eosinophilia and systemic symptoms (DRESS). BMJ Case Rep. 13 (2), e232302. https:\/\/doi.org\/10.1136\/bcr-2019-232302 (2020). PMID: 32024716; PMCID: PMC7021173.","journal-title":"BMJ Case Rep."},{"issue":"5","key":"42395_CR35","doi-asserted-by":"publisher","first-page":"e39348","DOI":"10.7759\/cureus.39348","volume":"15","author":"ES Obi","year":"2023","unstructured":"Obi, E. S. et al. Immune thrombocytopenia: a rare adverse event of vancomycin therapy. Cureus 15 (5), e39348. https:\/\/doi.org\/10.7759\/cureus.39348 (2023). PMID: 37351249; PMCID: PMC10284564.","journal-title":"Cureus"},{"key":"42395_CR36","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1038\/ki.2010.35","volume":"77","author":"SJ Vandecasteele","year":"2010","unstructured":"Vandecasteele, S. J. & De Vriese, A. S. Recent changes in vancomycin use in renal failure. Kidney Int. 77, 760\u2013764 (2010).","journal-title":"Kidney Int."},{"key":"42395_CR37","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ijantimicag.2010.10.013","volume":"37","author":"A Wong-Beringer","year":"2011","unstructured":"Wong-Beringer, A., Joo, J., Tse, E. & Beringer, P. Vancomycin associated nephrotoxicity: a critical appraisal of risk with high dose therapy. Int. J. Antimicrob. Agents. 37, 95\u2013101 (2011).","journal-title":"Int. J. Antimicrob. Agents"},{"key":"42395_CR38","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1093\/jac\/dkn080","volume":"62","author":"PR Ingram","year":"2008","unstructured":"Ingram, P. R. et al. Risk factors for nephrotoxicity associated with continuous vancomycin infusion in outpatient parenteral antibiotic therapy. J. Antimicrob. Chemother. 62, 168\u2013171 (2008).","journal-title":"J. Antimicrob. Chemother."},{"key":"42395_CR39","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.clinthera.2007.06.014","volume":"29","author":"MN Jeffres","year":"2007","unstructured":"Jeffres, M. N., Isakow, W., Doherty, J. A., Micek, S. T. & Kollef, M. H. A retrospective analysis of possible renal toxicity associated with vancomycin in patients with health care-associated methicillin resistant Staphylococcus aureus pneumonia. Clin. Ther. 29, 1107\u20131115 (2007).","journal-title":"Clin. Ther."},{"key":"42395_CR40","first-page":"195","volume":"44","author":"C Long","year":"2011","unstructured":"Long, C., Amin, N. C. & Manan, M. Population pharmacokinetics of vancomycin in hospitalized adult patients at a Malaysian tertiary care hospital. Eur. J. Pharm. Sci. 44, 195\u2013196 (2011).","journal-title":"Eur. J. Pharm. Sci."},{"issue":"3","key":"42395_CR41","doi-asserted-by":"publisher","first-page":"196","DOI":"10.4212\/cjhp.v63i3.915","volume":"63","author":"LM van de Vijsel","year":"2010","unstructured":"van de Vijsel, L. M. et al. Initial vancomycin dosing recommendations for critically ill patients undergoing continuous venovenous hemodialysis. Can. J. Hosp. Pharm. 63 (3), 196\u2013206. https:\/\/doi.org\/10.4212\/cjhp.v63i3.915 (2010). PMID: 22478979; PMCID: PMC2901779.","journal-title":"Can. J. Hosp. Pharm."},{"key":"42395_CR42","doi-asserted-by":"publisher","unstructured":"V\u00e1zquez, M., Fagiolino, P., Boronat, A., Buroni, M. & Maldonado, C. Therapeutic drug monitoring of vancomycin in severe sepsis and septic shock. Int. J. Clin. Pharmacol. Ther. 46(3), 140\u2013145. https:\/\/doi.org\/10.5414\/cpp46140 (2008). PMID: 18397685.","DOI":"10.5414\/cpp46140"},{"key":"42395_CR43","unstructured":"Lau, A. H. & John, E. Elimination of vancomycin by continuous arteriovenous hemofiltration. Child Nephrol. Urol. 9(4), 232\u2013235 (1988\u20131989). PMID: 3255486."},{"key":"42395_CR44","doi-asserted-by":"publisher","unstructured":"Badran, E. F., Shamayleh, A. & Irshaid, Y. M. Pharmacokinetics of vancomycin in neonates admitted to the neonatology unit at the Jordan University Hospital. Int. J. Clin. Pharmacol. Ther. 49(4), 252\u2013257. https:\/\/doi.org\/10.5414\/CP201456 (2011). PMID: 21429439.","DOI":"10.5414\/CP201456"},{"key":"42395_CR45","doi-asserted-by":"publisher","unstructured":"Golestaneh, L., Gofran, A., Mokrzycki, M. H. & Chen, J. L. Removal of vancomycin in sustained low-efficiency dialysis (SLED): a need for better surveillance and dosing. Clin. Nephrol. 72(4), 286\u2013291. https:\/\/doi.org\/10.5414\/cnp72286 (2009). PMID: 19825334.","DOI":"10.5414\/cnp72286"},{"issue":"4","key":"42395_CR46","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.burns.2009.08.010","volume":"36","author":"M Dolton","year":"2010","unstructured":"Dolton, M. et al. Vancomycin pharmacokinetics in patients with severe burn injuries. Burns 36 (4), 469\u2013476 (2010). Epub 2009 Oct 28. PMID: 19875238.","journal-title":"Burns"},{"key":"42395_CR47","doi-asserted-by":"publisher","unstructured":"Fern\u00e1ndez de Gatta, M. D. et al. Cost-effectiveness analysis of serum vancomycin concentration monitoring in patients with hematologic malignancies. Clin. Pharmacol. Ther. 60(3):332\u2013340. https:\/\/doi.org\/10.1016\/S0009-9236(96)90060-0 (1996). PMID: 8841156.","DOI":"10.1016\/S0009-9236(96)90060-0"},{"key":"42395_CR48","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1248\/bpb.25.1333","volume":"25","author":"H Teramachi","year":"2002","unstructured":"Teramachi, H. et al. Evaluation of predictability for vancomycin dosage regimens by the Bayesian method with Japanese population pharmacokinetic parameters. Biol. Pharm. Bull. 25, 1333\u20131338 (2002).","journal-title":"Biol. Pharm. Bull."},{"key":"42395_CR49","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1345\/aph.1P634","volume":"45","author":"MO Nunn","year":"2011","unstructured":"Nunn, M. O. et al. Vancomycin dosing: assessment of time to therapeutic concentration and predictive accuracy of pharmacokinetic modeling software. Ann. Pharmacother. 45, 757\u2013763 (2011).","journal-title":"Ann. Pharmacother"},{"key":"42395_CR50","doi-asserted-by":"publisher","first-page":"182e1","DOI":"10.1016\/j.amjmed.2009.05.031","volume":"123","author":"KA Hazlewood","year":"2010","unstructured":"Hazlewood, K. A., Brouse, S. D., Pitcher, W. D. & Hall, R. G. Vancomy cin-associated nephrotoxicity: grave concern or death by char acter assassination? Am. J. Med. 123, 182e1\u2013182e7 (2010).","journal-title":"Am. J. Med."},{"key":"42395_CR52","doi-asserted-by":"publisher","unstructured":"Wilhelm, M. P. & Estes, L. Symposium on antimicrobial agents\u2013Part XII. Vancomycin. Mayo Clin. Proc. 74(9), 928\u2013935. https:\/\/doi.org\/10.4065\/74.9.928 (1999). PMID: 10488798.","DOI":"10.4065\/74.9.928"},{"issue":"3","key":"42395_CR53","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s10156-013-0599-4","volume":"19","author":"K Matsumoto","year":"2013","unstructured":"Matsumoto, K. et al. Practice guidelines for therapeutic drug monitoring of vancomycin: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring. J. Infect. Chemother. 19 (3), 365\u2013380. https:\/\/doi.org\/10.1007\/s10156-013-0599-4 (2013). Epub 2013 May 15. PMID: 23673472.","journal-title":"J. Infect. Chemother."},{"key":"42395_CR54","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/S0025-6196(25)08316-8","volume":"33","author":"JE Geraci","year":"1958","unstructured":"Geraci, J. E., Heilman, F. R., Nichols, D. R. & Wellman, W. E. Antibiotic therapy of bacterial endocarditis. VII. Vancomycin for acute micrococcal endocarditis; preliminary report. Proc. Staff Meet Mayo Clin. 33, 172\u2013181 (1958).","journal-title":"Proc. Staff Meet Mayo Clin."},{"issue":"5","key":"42395_CR55","first-page":"376","volume":"3","author":"GR Bailie","year":"1988","unstructured":"Bailie, G. R. & Neal, D. Vancomycin ototoxicity and nephrotoxicity: a review. Med. Toxicol. Advers. Drug Exp. 3 (5), 376\u2013386 (1988).","journal-title":"Med. Toxicol. Advers. Drug Exp."},{"key":"42395_CR56","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1128\/AAC.01088-08","volume":"53","author":"A Forouzesh","year":"2009","unstructured":"Forouzesh, A., Moise, P. A. & Sakoulas, G. Vancomycin ototoxicity: a reevaluation in an era of increasing doses. Antimicrob. Agents Chemother. 53, 483\u2013486 (2009).","journal-title":"Antimicrob. Agents Chemother."},{"issue":"11","key":"42395_CR57","doi-asserted-by":"publisher","first-page":"e0224561","DOI":"10.1371\/journal.pone.0224561","volume":"14","author":"C Humphrey","year":"2019","unstructured":"Humphrey, C., Veve, M. P., Walker, B. & Shorman, M. A. Long-term vancomycin use had low risk of ototoxicity. PLoS One. 14 (11), e0224561. https:\/\/doi.org\/10.1371\/journal.pone.0224561 (2019). PMID: 31693679; PMCID: PMC6834250.","journal-title":"PLoS One"},{"key":"42395_CR58","unstructured":"Bruniera, F. R. et al. da Luz Gon\u00e7alves Pedreira FL. The use of vancomycin with its therapeutic and adverse effects: a review. Eur. Rev. Med. Pharmacol. Sci. 19(4), 694\u2013700. PMID: 25753888. (2015)."},{"key":"42395_CR59","doi-asserted-by":"publisher","unstructured":"Pritchard, L. et al. Increasing vancomycin serum trough concentrations and incidence of nephrotoxicity. Am. J. Med. 123(12):1143\u20131149. https:\/\/doi.org\/10.1016\/j.amjmed.2010.07.025 (2010). PMID: 21183005.","DOI":"10.1016\/j.amjmed.2010.07.025"},{"key":"42395_CR60","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.23.1.138","author":"BF Farber","year":"1983","unstructured":"Farber, B. F. & Moellering, R. C. Jr Retrospective study of the toxicity of preparations of vancomycin from 1974 to 1981. Antimicrob. Agents Chemother. ;23(1):138\u2013141. doi: https:\/\/doi.org\/10.1128\/AAC.23.1.138. (1983). PMID: 6219616; PMCID: PMC184631."},{"issue":"12","key":"42395_CR61","doi-asserted-by":"publisher","first-page":"5475","DOI":"10.1128\/AAC.00168-11","volume":"55","author":"JA Bosso","year":"2011","unstructured":"Bosso, J. A. et al. Relationship between vancomycin trough concentrations and nephrotoxicity: a prospective multicenter trial. Antimicrob. Agents Chemother. 55 (12), 5475\u20135479. https:\/\/doi.org\/10.1128\/AAC.00168-11 (2011). Epub 2011 Sep 26. PMID: 21947388; PMCID: PMC3232787.","journal-title":"Antimicrob. Agents Chemother."},{"key":"42395_CR62","doi-asserted-by":"publisher","unstructured":"Rybak, M. J. The pharmacokinetic and pharmacodynamic properties of vancomycin. Clin. Infect. Dis. 42(Suppl 1), S35\u2013S39. https:\/\/doi.org\/10.1086\/491712 (2006). PMID: 16323118.","DOI":"10.1086\/491712"},{"key":"42395_CR63","doi-asserted-by":"publisher","first-page":"925","DOI":"10.2165\/00003088-200443130-00005","volume":"43","author":"PA Moise-Broder","year":"2004","unstructured":"Moise-Broder, P. A., Forrest, A., Birmingham, M. C. & Schentag, J. J. Pharmacodynamics of vancomycin and other antimicrobials in patients with Staphylococcus aureus lower respiratory tract infections. Clin. Pharmacokinet. 43, 925\u2013942 (2004).","journal-title":"Clin. Pharmacokinet."},{"key":"42395_CR64","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1093\/cid\/cir124","volume":"52","author":"R Kullar","year":"2011","unstructured":"Kullar, R., Davis, S. L., Levine, D. P. & Rybak, M. J. Impact of vanco mycin exposure on outcomes in patients with methicillin-resis tant Staphylococcus aureus bacteremia: support for consensus guidelines suggested targets. Clin. Infect. Dis. 52, 975\u2013981 (2011).","journal-title":"Clin. Infect. Dis."},{"key":"42395_CR65","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1093\/cid\/ciq146","volume":"52","author":"C Liu","year":"2011","unstructured":"Liu, C. et al. Infectious Diseases Society of America. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococ cus aureus infections in adults and children. Clin. Infect. Dis. 52, e18\u201355 (2011).","journal-title":"Clin. Infect. Dis."},{"key":"42395_CR66","unstructured":"Christiansen, K. et al. Therapeutic guidelines: antibiotic 14th edn (Therapeutic Guidelines Limited, 2010)."},{"issue":"1","key":"42395_CR67","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12879-021-05858-6","volume":"21","author":"M Tsutsuura","year":"2021","unstructured":"Tsutsuura, M. et al. The monitoring of vancomycin: a systematic review and meta-analyses of area under the concentration-time curve-guided dosing and trough-guided dosing. BMC Infect. Dis. 21 (1), 153. https:\/\/doi.org\/10.1186\/s12879-021-05858-6 (2021). PMID: 33549035; PMCID: PMC7866743.","journal-title":"BMC Infect. Dis."},{"key":"42395_CR68","doi-asserted-by":"publisher","unstructured":"Patel, K., Crumby, A. S. & Maples, H. D. Balancing vancomycin efficacy and nephrotoxicity: should we be aiming for trough or AUC\/MIC? Paediatr Drugs. 17(2), 97\u2013103. https:\/\/doi.org\/10.1007\/s40272-015-0117-5 (2015). PMID: 25644329.","DOI":"10.1007\/s40272-015-0117-5"},{"issue":"11","key":"42395_CR69","doi-asserted-by":"publisher","first-page":"6454","DOI":"10.1128\/AAC.03620-14","volume":"58","author":"A Frymoyer","year":"2014","unstructured":"Frymoyer, A. et al. Association between vancomycin trough concentration and area under the concentration-time curve in neonates. Antimicrob. Agents Chemother. 58 (11), 6454\u20136461. https:\/\/doi.org\/10.1128\/AAC.03620-14 (2014). Epub 2014 Aug 18. PMID: 25136027; PMCID: PMC4249374.","journal-title":"Antimicrob. Agents Chemother."},{"key":"42395_CR70","doi-asserted-by":"publisher","unstructured":"McKamy, S. et al. Incidence and risk factors influencing the development of vancomycin nephrotoxicity in children. J. Pediatr. 158(3), 422\u2013426. https:\/\/doi.org\/10.1016\/j.jpeds.2010.08.019. PMID: 20888013. (2011).","DOI":"10.1016\/j.jpeds.2010.08.019"},{"issue":"4","key":"42395_CR71","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1186\/cc1516","volume":"6","author":"V Launay-Vacher","year":"2002","unstructured":"Launay-Vacher, V., Izzedine, H., Mercadal, L. & Deray, G. Clinical review: use of vancomycin in haemodialysis patients. Crit. Care. 6 (4), 313\u2013316. https:\/\/doi.org\/10.1186\/cc1516 (2002). Epub 2002 Jun 10. PMID: 12225605; PMCID: PMC137311.","journal-title":"Crit. Care"},{"issue":"1","key":"42395_CR72","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3904\/kjim.2009.24.1.1","volume":"24","author":"JS Kang","year":"2009","unstructured":"Kang, J. S. & Lee, M. H. Overview of therapeutic drug monitoring. Korean J. Intern. Med. 24 (1), 1 (2009).","journal-title":"Korean J. Intern. Med."},{"key":"42395_CR73","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.ijantimicag.2009.07.011","volume":"34","author":"PR Ingram","year":"2009","unstructured":"Ingram, P. R., Lye, D. C., Fisher, D. A., Goh, W. P. & Tam, V. H. Nephro toxicity of continuous versus intermittent infusion of vanco mycin in outpatient parenteral antimicrobial therapy. Int. J. Antimicrob. Agents. 34, 570\u2013574 (2009).","journal-title":"Int. J. Antimicrob. Agents"},{"key":"42395_CR74","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1097\/ALN.0b013e3181a97272","volume":"111","author":"D Hutschala","year":"2009","unstructured":"Hutschala, D. et al. Influence of vancomycin on renal function in critically ill patients after cardiac surgery: continuous versus intermittent infusion. Anesthesiology 111, 356\u2013365 (2009).","journal-title":"Anesthesiology"},{"key":"42395_CR75","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1093\/jac\/dkr442","volume":"67","author":"MA Cataldo","year":"2012","unstructured":"Cataldo, M. A., Tacconelli, E., Grilli, E., Pea, F. & Petrosillo, N. Con tinuous versus intermittent infusion of vancomycin for the treatment of gram-positive infections: systematic review and meta-analysis. J. Antimicrob. Chemother. 67, 17\u201324 (2012).","journal-title":"J. Antimicrob. Chemother."},{"issue":"5","key":"42395_CR76","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1093\/cid\/cir895","volume":"54","author":"R. G. Wunderink","year":"2012","unstructured":"Wunderink, R. G. et al. Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study. Clin. Infect. Dis. 54 (5), 621\u2013629. (2012). https:\/\/doi.org\/10.1093\/cid\/cir895","journal-title":"Clin. Infect. Dis."},{"issue":"3","key":"42395_CR77","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1002\/cpt.726","volume":"102","author":"EJ Filippone","year":"2017","unstructured":"Filippone, E. J., Kraft, W. K. & Farber, J. L. The nephrotoxicity of vancomycin. Clin. Pharmacol. Ther. 102 (3), 459\u2013469 (2017).","journal-title":"Clin. Pharmacol. Ther."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42395-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42395-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42395-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:47:20Z","timestamp":1778658440000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42395-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":76,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["42395"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-42395-1","relation":{"references":[{"id-type":"doi","id":"10.1128\/AAC.23.1.138","asserted-by":"subject"}],"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7437818\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]},"assertion":[{"value":"23 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki. The MIMIC-IV database has received ethical approval from the Institutional Review Boards (IRBs) at Beth Israel Deaconess Medical Center and Massachusetts Institute of Technology. Because the database is publicly available and contains no protected health information, the requirement for ethical approval and informed consent for this study was waived.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All authors have read and approved the final manuscript and consent to its publication in this journal.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"15009"}}