{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T21:45:41Z","timestamp":1782423941506,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T00:00:00Z","timestamp":1564444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vancomycin is the default antibiotic to treat methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) in hemodialysis (HD) units. Current guidelines recommend a vancomycin trough range of 15 to 20\u2009mg\/L for serious infections. Data regarding the clinical success of these recommendations are scarce in HD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this studies is to evaluate the treatment outcomes of vancomycin in HD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review of HD outpatients who received parenteral vancomycin for suspected or documented MRSA infections in a community hospital in southwestern Ontario, Canada. Stepwise binary logistic regression analysis was conducted to identify the independent predictors of the treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 77 HD patients, 113 vancomycin treatment courses were identified. The unadjusted bivariate comparisons suggested that there was no difference between treatment success and failure groups in terms of: mean loading dose (1663.6\u2009\u00b1\u2009451.9\u2009mg vs. 1614.3\u2009\u00b1\u2009471\u2009mg, <jats:italic>P<\/jats:italic> = 0.621), mean pre\u2010HD concentration after loading dose (12.78\u2009\u00b1\u20094.4\u2009mg\/L vs. 13.34\u2009\u00b1\u20094.5\u2009mg\/L, <jats:italic>P<\/jats:italic> = 0.601), and mean maintenance dose (1012.1\u2009\u00b1\u2009108\u2009mg vs. 1069.7\u2009\u00b1\u2009227\u2009mg, <jats:italic>P<\/jats:italic> = 0.093). The groups were, however, different on their mean pre\u2010HD drug concentration after maintenance dose (15.99\u2009\u00b1\u20094.6\u2009mg\/L vs. 19.9\u2009\u00b1\u20095.8\u2009mg\/L, <jats:italic>P<\/jats:italic> = 0.002). The adjusted logistic regression results, however, suggested that the type of infection was the only independent predictor of vancomycin success (OR = 11.07; 95% confidence interval [CI] = 3.2\u201338.48). Specifically, patients treated for bacteremia were 11 times more likely to experience cure as compared with diabetic foot infection and\/or osteomyelitis. Similarly, those with skin and soft tissue infections were 10.7 times more likely to experience cure than those with diabetic foot infection and\/or osteomyelitis (OR = 10.7; 95% CI = 3.63\u201331.58).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The suggested vancomycin pre\u2010HD concentration in the guidelines did not predict the treatment outcomes. Patients with bacteremia and\/or skin or soft tissue infections were more likely to achieve clinical cure than patients with diabetic foot\/osteomyelitis infections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.12775","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T10:33:35Z","timestamp":1564482815000},"page":"449-457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors predicting vancomycin therapy outcomes in hemodialysis outpatients and the role of the nephrology stewardship pharmacist"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3109-0590","authenticated-orcid":false,"given":"Wasim S.","family":"El Nekidy","sequence":"first","affiliation":[{"name":"Cleveland Clinic Abu Dhabi  Abu Dhabi UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher M.","family":"El\u2010Masri","sequence":"additional","affiliation":[{"name":"College of Nursing Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1108-7706","authenticated-orcid":false,"given":"Islam M.","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Philadelphia College of Pharmacy at University of the Sciences  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick","family":"Soong","sequence":"additional","affiliation":[{"name":"Windsor Regional Hospital  Windsor Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.35"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2007.00333.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1073-4449(96)80022-7"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.06.014"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080434"},{"key":"e_1_2_5_7_1","unstructured":"Kindey Disease Statistics for the United States. 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