{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:32:11Z","timestamp":1787959931614,"version":"build-2784847793"},"reference-count":46,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100004169","name":"Meiji Seika Pharma","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004169","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002975","name":"Dainippon Sumitomo Pharma","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002975","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005612","name":"Shionogi","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005612","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              We aimed to assess the frequency of acute kidney injury (AKI) in different areas under the concentration\u2013time curve (AUC) values of vancomycin (VAN) using a two-point blood collection method, allowing for accurate AUC assessment in critically ill patients. This multicenter retrospective observational study was conducted in eight hospitals. We retrospectively analyzed the data of patients who had received VAN in an intensive care unit (ICU) between January 2020 and December 2022. The primary outcome was the incidence of AKI. Patients were classified into three groups according to the AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              at the initial therapeutic drug monitoring (TDM) as follows: &lt;500, 500\u2013600, and \u2265600 \u00b5g\u00b7h\/mL. The AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              values were calculated using the Bayesian estimation software Practical AUC-guided TDM. Among 146 patients [median age (interquartile range), 67 (56\u201378) years; 39% women], the AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              &lt;500 \u00b5g\u00b7h\/mL had an AKI rate of 6.5% (7\/107), the AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              500\u2013600 \u00b5g\u00b7h\/mL had an AKI rate of 28.0% (7\/25), and the AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              \u2265600 \u00b5g\u00b7h\/mL had an AKI rate of 42.9% (6\/14). In multivariate Cox proportional hazard analysis, the AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              500\u2013600 \u00b5g\u00b7h\/mL [hazard ratio 5.4, 95% confidence interval (CI) 1.64\u201317.63] and the AUC\n              <jats:sub>24\u201348h<\/jats:sub>\n              \u2265600 \u03bcg\u00b7h\/mL (hazard ratio 7.0, 95% CI 2.31\u201321.18) significantly correlated with a higher incidence of AKI compared with the AUC\n              <jats:sub>24-48h<\/jats:sub>\n              &lt;500 \u03bcg\u00b7h\/mL. In conclusion, we identified an association between AUC on day 2 and the risk of AKI in ICU patients, suggesting that not only AUCs above 600 \u00b5g\u00b7h\/mL but also those between 500 and 600 \u00b5g\u00b7h\/mL pose a risk for AKI.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              Vancomycin (VAN) is a glycopeptide antibiotic and one of the most commonly used antibiotics for severe infections caused by methicillin-resistant\n              <jats:italic>Staphylococcus aureus<\/jats:italic>\n              . However, higher VAN concentrations have been associated with an increased risk of acute kidney injury (AKI). Herein, we aimed to assess the frequency of AKI in different areas under the concentration\u2013time curve (AUC) values of VAN using a two-point blood collection method, allowing for accurate AUC assessment in critically ill patients. We identified an association between AUC on day 2 and the risk of AKI in intensive care unit patients, suggesting that not only AUCs above 600 \u00b5g\u00b7h\/mL but also those between 500 and 600 \u00b5g\u00b7h\/mL pose a risk for AKI. Therefore, individualized dosing is feasible, with pharmacists being able to optimize VAN doses to attain appropriate targets.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.03739-23","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T13:01:30Z","timestamp":1716382890000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":23,"title":["Relationship between nephrotoxicity and area under the concentration\u2013time curve of vancomycin in critically ill patients: a multicenter retrospective study"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2689-5338","authenticated-orcid":false,"given":"Tomoyuki","family":"Ishigo","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Sapporo Medical University Hospital, Sapporo, 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