{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:06:10Z","timestamp":1790611570047,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Current vancomycin monitoring guidelines recommend monitoring 24-hour area under the concentration-time curve (AUC) to minimum inhibitory concentration ratios for patients with serious methicillin-resistant Staphylococcus aureus infections. However, there are sparse data on the safety, feasibility, and efficacy of vancomycin AUC monitoring for outpatients. Traditional AUC pharmacokinetic calculations require 2 concentrations, while bayesian software allows for single-concentration AUC estimations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a single-center, quasi-experimental, interrupted time series study of patients enrolled in the outpatient parenteral antimicrobial therapy program at our institution for vancomycin management. Our institution implemented a pharmacist-driven vancomycin AUC monitoring program from September 2019 to February 2020, and again from September 2022 to March 2023. Patients enrolled underwent vancomycin monitoring using an AUC goal of 400\u2013600\u2005mg\u22c5h\/L, estimated through bayesian modeling. Patients enrolled in the outpatient parenteral antimicrobial therapy program from July 2021 through August 2022 for trough-based monitoring were used for comparison. The primary outcome was nephrotoxicity incidence, defined as a serum creatinine increase by \u22650.5\u2005mg\/dL or \u226550% during outpatient vancomycin therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 63 patients in the AUC group and 60 patients in the trough-based group. Nephrotoxicity was significantly lower in the AUC cohort (6.3% vs 23.3%; P = .01). The number of unusable vancomycin concentrations was also significantly lower in the AUC cohort (0% vs 6%; P &amp;lt; .01). There was no difference in composite 90-day all-cause mortality or readmission (33.3% vs 38.3%; P = .56).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Following implementation of a pharmacist-driven AUC monitoring program, patients were less likely to develop nephrotoxicity during outpatient vancomycin therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae600","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T08:32:14Z","timestamp":1729240334000},"source":"Crossref","is-referenced-by-count":10,"title":["Implementation of a Pharmacist-Driven Vancomycin Area Under the Concentration-Time Curve Monitoring Program Using Bayesian Modeling in Outpatient Parenteral Antimicrobial Therapy"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-8526","authenticated-orcid":false,"given":"Eric","family":"Gillett","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-5122","authenticated-orcid":false,"given":"Muneerah M","family":"Aleissa","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Department of Pharmacy Practice, Princess Nourah Bint Abdulrahman University , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5276-1050","authenticated-orcid":false,"given":"Jeffrey C","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-3326","authenticated-orcid":false,"given":"Daniel A","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3133-0945","authenticated-orcid":false,"given":"David W","family":"Kubiak","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2851-8883","authenticated-orcid":false,"given":"Brandon","family":"Dionne","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"School of Pharmacy and Pharmaceutical Sciences, Northeastern University , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba H","family":"Edrees","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetoun","family":"Okenla","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6971-3039","authenticated-orcid":false,"given":"Brian T","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"key":"2024112610412427400_ofae600-B1","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1128\/AAC.01568-12","article-title":"Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter","volume":"57","author":"Van Hal","year":"2013","journal-title":"Antimicrob Agents 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