{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T02:26:39Z","timestamp":1778811999606,"version":"3.51.4"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2016,5,1]],"date-time":"2016-05-01T00:00:00Z","timestamp":1462060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"HHS | National Institutes of Health","doi-asserted-by":"publisher","award":["TR000120-03"],"award-info":[{"award-number":["TR000120-03"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            While previous studies have examined the association between vancomycin (VAN) exposure and MIC with regard to outcomes in methicillin-resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Staphylococcus aureus<\/jats:named-content>\n            bacteremia (MRSA-B), none have explored if a relationship exists with the VAN minimum bactericidal concentration (MBC). The objective of this study was to evaluate the VAN 24-h area under the curve (AUC\n            <jats:sub>24<\/jats:sub>\n            )\/MBC ratio as a pharmacodynamic predictor of mortality. This retrospective cohort study included patients treated with VAN for MRSA-B with the primary outcome of 30-day all-cause mortality. Data collected included patient demographics, comorbidities, antimicrobial treatment data, therapeutic drug levels, and laboratory and microbiological data. Vancomycin MICs and MBCs were determined by Etest (MIC only) and broth microdilution (BMD). The vancomycin AUC\n            <jats:sub>24<\/jats:sub>\n            was determined by pharmacokinetic maximum\n            <jats:italic>a posteriori<\/jats:italic>\n            probability Bayesian (MAP-Bayesian) analysis. The most significant breakpoint for 30-day mortality was determined by classification and regression tree (CART) analysis. The association between pharmacodynamic parameters (VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MIC\n            <jats:sub>BMD<\/jats:sub>\n            , VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MIC\n            <jats:sub>Etest<\/jats:sub>\n            , and AUC\n            <jats:sub>24<\/jats:sub>\n            \/MBC\n            <jats:sub>BMD<\/jats:sub>\n            ) and mortality were determined by \u03c7\n            <jats:sup>2<\/jats:sup>\n            and multivariable Poisson regression. Overall mortality in this cohort (\n            <jats:italic>n<\/jats:italic>\n            = 53) was 20.8% (\n            <jats:italic>n<\/jats:italic>\n            = 11\/53), and all corresponding MRSA blood isolates were VAN susceptible (MIC range, 0.5 to 2 \u03bcg\/ml; MIC\n            <jats:sub>50<\/jats:sub>\n            , 1 \u03bcg\/ml; MIC\n            <jats:sub>90<\/jats:sub>\n            , 1 \u03bcg\/ml). The CART-derived breakpoints for mortality were 176 (VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MBC) and 334 (VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MIC\n            <jats:sub>BMD<\/jats:sub>\n            ). In multivariable analysis, the association between a VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MBC of \u2265176 and survival persisted, but VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MIC\n            <jats:sub>BMD<\/jats:sub>\n            values (\u2265334 or \u2265400) were not associated with improved mortality. In conclusion, VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MBC was a more important predictor of 30-day mortality than VAN AUC\n            <jats:sub>24<\/jats:sub>\n            \/MIC for MRSA-B.\n          <\/jats:p>","DOI":"10.1128\/aac.02714-15","type":"journal-article","created":{"date-parts":[[2016,3,8]],"date-time":"2016-03-08T03:39:18Z","timestamp":1457408358000},"page":"3070-3075","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":15,"title":["Vancomycin 24-Hour Area under the Curve\/Minimum Bactericidal Concentration Ratio as a Novel Predictor of Mortality in Methicillin-Resistant Staphylococcus aureus Bacteremia"],"prefix":"10.1128","volume":"60","author":[{"given":"Nicholas S.","family":"Britt","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, University of Kansas School of Pharmacy, Lawrence, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nimish","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca T.","family":"Horvat","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly E.","family":"Steed","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, University of Kansas School of Pharmacy, Lawrence, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/528716"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e3283578968"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2012.07.023"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2012.08.005"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00113-08"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00939-06"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01536-10"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.6.2398-2402.2004"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-279"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ308"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.29.11.1275"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir124"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1086\/313650"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-198907000-00013"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-198905000-00009"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir078"},{"key":"e_1_3_1_18_2","volume-title":"Approved standard M7-A9","author":"Clinical and Laboratory Standards Institute","year":"2011","unstructured":"Clinical and Laboratory Standards Institute. 2011. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, 9th ed. Approved standard M7-A9. Clinical and Laboratory Standards Institute, Wayne, PA, USA.","edition":"9"},{"key":"e_1_3_1_19_2","volume-title":"Approved guideline M26-A","author":"Clinical and Laboratory Standards Institute","year":"1999","unstructured":"Clinical and Laboratory Standards Institute. 1999. Methods for determining bactericidal activity of antimicrobial agents. Approved guideline M26-A. 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