{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:41:18Z","timestamp":1791996078948,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Evidence on the optimal targets of vancomycin for treating other Gram\u2010positive infections apart from methicillin\u2010resistant <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content> (MRSA) is lacking. This review aims to identify the recommended vancomycin therapeutic level for favourable clinical outcomes among patients infected with vancomycin\u2010sensitive enterococcal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analytical studies describing the vancomycin levels of vancomycin\u2010sensitive enterococcal infections among adult population were searched. The primary outcome was 30\u2010day all\u2010cause mortality, and the secondary outcomes were clinical failure and nephrotoxicity. Study characteristics were extracted and pooled using random\u2010effects meta\u2010analysis. The study quality was assessed using the Joanna Briggs Institute critical appraisal tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of nine retrospective cohorts studies involving 1013 patients with vancomycin\u2010sensitive enterococci were included. The meta\u2010analysis found that high area under the curve to minimum inhibitory concentration ratio (AUC\/MIC) of vancomycin \u2265 389\u2009mg*h\/L significantly lowered the 30\u2010day mortality (odds ratio [OR], 0.44, 95% confidence interval [CI], 0.26\u20130.75). Analysis of the target AUC\/MIC showed that high vancomycin AUC\/MIC (\u2265 389\u2013400\u2009mg*h\/L) significantly reduced clinical failure rate (OR 0.59, 95% CI 0.37\u20130.94). The mortality and treatment failure rates did not differ significantly between those with high or low trough levels. Higher vancomycin AUC\/MIC and trough levels were significantly associated with increased nephrotoxicity (OR 3.11, 95% CI 1.65\u20135.89; OR 2.95, 95% CI 1.60\u20135.44, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of a higher vancomycin AUC\/MIC concentration can be effective to reduce 30\u2010day mortality and clinical failure but this needs to take into consideration the risk of nephrotoxicity. Well\u2010conducted prospective studies are warranted due to the scarcity of evidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16362","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T07:35:33Z","timestamp":1733729733000},"page":"1250-1262","source":"Crossref","is-referenced-by-count":6,"title":["Systematic review and meta\u2010analysis of vancomycin therapeutic level for treatment of vancomycin\u2010sensitive enterococcal infections"],"prefix":"10.1111","volume":"91","author":[{"given":"Wasan","family":"Katip","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Care, Faculty of Pharmacy Chiang Mai University  Chiang Mai Thailand"},{"name":"Epidemiological and Innovative Research Group for Infectious Diseases (EIRGID) Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7361-6576","authenticated-orcid":false,"given":"Shaun Wen Huey","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Pharmacy Monash University Malaysia, Jalan Lagoon Selatan  Bandar Sunway Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nongyao","family":"Kasatpibal","sequence":"additional","affiliation":[{"name":"Epidemiological and Innovative Research Group for Infectious Diseases (EIRGID) Chiang Mai University  Chiang Mai Thailand"},{"name":"Division of Nursing Science, Faculty of Nursing Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5961-8978","authenticated-orcid":false,"given":"Ajaree","family":"Rayanakorn","sequence":"additional","affiliation":[{"name":"Epidemiological and Innovative Research Group for Infectious Diseases (EIRGID) Chiang Mai University  Chiang Mai Thailand"},{"name":"Department of Pharmacology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,8]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Enterococcus infections","author":"Said M","year":"2022"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.296"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11121698"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01602\u201017"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080434"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10156\u2010013\u20100599\u20104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxaa036"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190016642692"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01653\u201013"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/57.suppl_2.S4"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc2872"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000064"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.46658\/JBIRM\u201017\u201006"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12633"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2023.07.010"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40780\u2010019\u20100138\u20102"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12111577"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm\u20102022\u2010003672"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics13091378"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.773994"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010022\u201007668\u2010w"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010021\u201006809\u2010x"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14061266"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.726"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05920616"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1086\/597031"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01293\u201017"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy680"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad202"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa184"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1R158"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104\u2010016\u20102252\u20107"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1159\/000343162"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1086\/600884"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02535\u201016"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2020.106109"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23042052"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02432\u201013"}],"container-title":["British Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bcp.16362","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T09:42:49Z","timestamp":1744450969000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/10.1111\/bcp.16362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,8]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/bcp.16362"],"URL":"https:\/\/doi.org\/10.1111\/bcp.16362","archive":["Portico"],"relation":{},"ISSN":["0306-5251","1365-2125"],"issn-type":[{"value":"0306-5251","type":"print"},{"value":"1365-2125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,8]]}}}