{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:08:10Z","timestamp":1780063690634,"version":"3.54.0"},"reference-count":25,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2017,5,1]],"date-time":"2017-05-01T00:00:00Z","timestamp":1493596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Unlike vancomycin trough concentrations, data on the utility of vancomycin pharmacokinetic (PK) parameters, namely, the area under the concentration-time curve from 0 to 24 h (AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            ), in predicting acute kidney injury (AKI) are limited. Our aim was to investigate this relationship in patients receiving vancomycin therapy for methicillin-resistant\n            <jats:named-content content-type=\"genus-species\">Staphylococcus aureus<\/jats:named-content>\n            bacteremia (MRSA-B). A single-center retrospective observational cohort study involving 127 consecutive MRSA-B patients was conducted to examine the incidence of AKI (defined as serum creatinine of \u22650.5 mg\/liter and a 50% increase from baseline) and vancomycin exposure parameters associated with nephrotoxicity. Bayesian estimation was used to predict individual vancomycin AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            . All patients received vancomycin monotherapy for a minimum of 14 days following the diagnosis of MRSA-B. AKI was observed in 15.7% of patients (20\/127). Clinical characteristics were similar between patients with and without AKI. At steady state, higher vancomycin trough concentrations were associated with AKI (17.2 mg\/liter versus 13.1 mg\/liter;\n            <jats:italic>P<\/jats:italic>\n            = 0.003). A vancomycin AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            threshold for AKI of &gt;563 mg \u00b7 h\/liter was detected by classification and regression tree (CART) analysis; patients with exposures above this threshold were significantly more likely to experience AKI than patients with lower vancomycin exposures (40% [8\/20] versus 11.2% [12\/107];\n            <jats:italic>P<\/jats:italic>\n            = 0.002). This parameter remained an independent predictor of AKI on multivariate logistic regression (odds ratio [OR], 5.07; 95% confidence interval [CI], 1.57 to 16.29;\n            <jats:italic>P<\/jats:italic>\n            = 0.006) and was a better predictor of nephrotoxicity than vancomycin trough concentrations. Overall, AKI is associated with higher vancomycin exposure as measured by AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            . These results suggest that individualized patient dosing may be possible with dose modifications directed toward established pharmacodynamic targets while balancing AKI risks.\n          <\/jats:p>","DOI":"10.1128\/aac.02535-16","type":"journal-article","created":{"date-parts":[[2017,2,28]],"date-time":"2017-02-28T01:40:27Z","timestamp":1488246027000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":79,"title":["Establishment of an AUC\n            <sub>0\u201324<\/sub>\n            Threshold for Nephrotoxicity Is a Step towards Individualized Vancomycin Dosing for Methicillin-Resistant Staphylococcus aureus Bacteremia"],"prefix":"10.1128","volume":"61","author":[{"given":"R.","family":"Chavada","sequence":"first","affiliation":[{"name":"Department of Microbiology and Infectious Diseases, Gosford, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and General Medicine, Wollongong and Shellharbour Hospitals, Wollongong, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Sandaradura","sequence":"additional","affiliation":[{"name":"Department of Microbiology, St. Vincent's Hospital, Sydney, NSW, Australia"},{"name":"University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Maley","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infectious Diseases, Liverpool, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Van Hal","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq146"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp065"},{"key":"e_1_3_2_4_2","unstructured":"Therapeutic Guidelines Ltd. Antibiotic eTG version 15. Severe sepsis and septic shock: Staphylococcus aureus. Accessed 15 June 2015. https:\/\/tgldcdp.tg.org.au.acs.hcn.com.au\/severe-sepsis."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2010.10.013"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080434"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01653-13"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/600884"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1638"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01568-12"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-012-1259-9"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000635"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01602-07"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200443130-00005"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn080"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000343162"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piu110"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.19.2138"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12695"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu398"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01485-12"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfs160"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr442"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000514"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0897190016642692"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.12.4934-4941.2005"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.02535-16","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.02535-16","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T20:55:13Z","timestamp":1645476913000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.02535-16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1128\/AAC.02535-16"],"URL":"https:\/\/doi.org\/10.1128\/aac.02535-16","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5]]},"assertion":[{"value":"2016-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-04-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e02535-16"}}