{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:50:53Z","timestamp":1781189453713,"version":"3.54.1"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>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. The most recent Infectious Diseases Society of America publication regarding therapeutic monitoring of vancomycin recommends using area under the curve (AUC)-based monitoring to maximize clinical success. Despite the guideline recommendation for AUC-guided dosing, many institutions still use trough-only monitoring in their practices, including those caring for patients with acute burn injuries. Following burn injury, patients are at a higher risk for infections, multiorgan failure, and pharmacokinetic alterations. The primary objective of this multicenter retrospective study is to determine optimal therapeutic monitoring of vancomycin by comparing clinical success between AUC and trough-based monitoring in patients with burns. MONITOR was a multicenter, retrospective study of patients with thermal or inhalation injury admitted to one of 13 burn centers from January 1, 2017 to August 31, 2022 who received vancomycin. Demographic and clinical course data, including acute kidney injury (AKI) incidence and clinical success, were obtained. Patients were evaluated for clinical success and grouped according to method of monitoring and adjusting doses: AUC vs trough-based monitoring. Clinical success was a composite definition and lack of meeting any 1 of 5 criteria: (1) persistent infection, (2) relapse, (3) antibiotic failure (clinical worsening), (4) AKI, and (5) death. A total of 517 vancomycin courses were assessed from 485 patients. There was no difference in the rate of clinical success between AUC monitored and the trough-only monitored groups. Incidence of AKI was higher in the trough-only group; however, it was not statistically significant after controlling for renal function on admission, past medical history of chronic kidney disease, and concomitant nephrotoxins.<\/jats:p>","DOI":"10.1093\/jbcr\/irae109","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T17:39:18Z","timestamp":1718905158000},"page":"1383-1389","source":"Crossref","is-referenced-by-count":2,"title":["A Multicenter, Retrospective Outcome Analysis of Vancomycin Area Under the Curve Versus Trough-Based Dosing Strategies in Patients With Burn OR Inhalational Injuries (MONITOR)"],"prefix":"10.1093","volume":"45","author":[{"given":"Richard M","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Regional One Health , Memphis, TN 38103 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9412-5899","authenticated-orcid":false,"given":"Allison N","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Eskenazi Health , Indianapolis, IN 46202 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6861-6408","authenticated-orcid":false,"given":"Todd A","family":"Walroth","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Eskenazi Health , Indianapolis, IN 46202 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5001-611X","authenticated-orcid":false,"given":"Alexandria","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Harborview Medical Center , Seattle, WA 98104 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"King","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Harborview Medical Center , Seattle, WA 98104 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5963-3097","authenticated-orcid":false,"given":"Aileen","family":"Ahiskali","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hennepin Healthcare , Minneapolis, MN 55415 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hennepin Healthcare , Minneapolis, MN 55415 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichole","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hennepin Healthcare , Minneapolis, MN 55415 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1431-4911","authenticated-orcid":false,"given":"Dominick","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Orlando Health , Orlando, FL 32806 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0678-315X","authenticated-orcid":false,"given":"Brittany","family":"Hoyte","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Corewell Health West , Grand Rapids, MI 49503 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Corewell Health West , Grand Rapids, MI 49503 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8917-2698","authenticated-orcid":false,"given":"Beatrice","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Tampa General Hospital , Tampa, FL 33606 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Tampa General Hospital , Tampa, FL 33606 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa M","family":"Gleason","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Thomas Jefferson University Hospital , Philadelphia, PA 19107 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-5433","authenticated-orcid":false,"given":"Zachary","family":"Drabick","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Florida Health Shands Hospital , Gainesville, FL 32608 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6912-6298","authenticated-orcid":false,"given":"Alexandra","family":"DeWitt","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University Medical Center New Orleans , New Orleans, LA 70112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Suarez","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care, University of Iowa Health Care Medical Center , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1271-476X","authenticated-orcid":false,"given":"Ann Marie B","family":"Prazak","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, University of Utah Health , Salt Lake City, UT 84132 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7265-0665","authenticated-orcid":false,"given":"Kathryn A","family":"Disney","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, University of Utah Health , Salt Lake City, UT 84132 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1119-1901","authenticated-orcid":false,"given":"David M","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Regional One Health , Memphis, TN 38103 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"issue":"1","key":"2024111510200388300_CIT0001","doi-asserted-by":"crossref","first-page":"82","DOI":"10.2146\/ajhp080434","article-title":"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","volume":"66","author":"Rybak","year":"2009","journal-title":"Am J Health Syst Pharm"},{"issue":"11","key":"2024111510200388300_CIT0002","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/ajhp\/zxaa036","article-title":"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","volume":"77","author":"Rybak","year":"2020","journal-title":"Am J Health Syst Pharm"},{"issue":"3","key":"2024111510200388300_CIT0003","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.burns.2017.10.004","article-title":"Characterization of variables for potential impact on vancomycin pharmacokinetics in thermal or inhalation injury","volume":"44","author":"Elder","year":"2018","journal-title":"Burns"},{"issue":"2","key":"2024111510200388300_CIT0004","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.burns.2018.09.025","article-title":"Optimization of an empiric vancomycin dosing algorithm for improved target concentration attainment in patients with thermal injury","volume":"45","author":"Hill","year":"2019","journal-title":"Burns"},{"issue":"7","key":"2024111510200388300_CIT0005","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.burns.2021.08.016","article-title":"Continuous infusion versus intermittent infusion vancomycin in a burn center intensive care unit","volume":"47","author":"Schlobohm","year":"2021","journal-title":"Burns"},{"issue":"3","key":"2024111510200388300_CIT0006","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/j.burns.2010.06.005","article-title":"Optimizing initial vancomycin dosing in burn patients","volume":"37","author":"Elligsen","year":"2011","journal-title":"Burns"},{"issue":"2","key":"2024111510200388300_CIT0007","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1093\/jbcr\/irac147","article-title":"Exploring the past to inform the future to optimize the pharmacokinetics of vancomycin in children with severe burn injuries","volume":"44","author":"Sherwin","year":"2023","journal-title":"J Burn Care Res"},{"issue":"6","key":"2024111510200388300_CIT0008","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1097\/BCR.0000000000000191","article-title":"A systematic review of vancomycin dosing and monitoring in burn patients","volume":"36","author":"Carter","year":"2015","journal-title":"J Burn Care Res"},{"issue":"1","key":"2024111510200388300_CIT0009","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1097\/IPC.0000000000000531","article-title":"A comparison of nephrotoxicity in non\u2013intensive care unit medical-surgical patients receiving vancomycin alone versus vancomycin with piperacillin-tazobactam","volume":"26","author":"Eberle","year":"2018","journal-title":"Infect Dis Clin Pract"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/irae109\/58460287\/irae109.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/45\/6\/1383\/60679045\/irae109.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/45\/6\/1383\/60679045\/irae109.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T10:20:07Z","timestamp":1731666007000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/45\/6\/1383\/7696645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,20]]},"references-count":9,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,20]]},"published-print":{"date-parts":[[2024,11,14]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/irae109","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,11]]},"published":{"date-parts":[[2024,6,20]]}}}