{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:17:28Z","timestamp":1788182248957,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Fuyang City Key Research and Development Plan for Clinical Medical Research Translation Special Project","award":["FYZDYF2023LCYX012"],"award-info":[{"award-number":["FYZDYF2023LCYX012"]}]},{"name":"Anhui Provincial Health Research Project","award":["AHWJ2023A30162"],"award-info":[{"award-number":["AHWJ2023A30162"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"abstract":"\n Background:<\/jats:title>\n Laboratory-defined leukopenia\/neutropenia may occur during vancomycin therapy, but mild threshold-crossing abnormalities do not necessarily establish definite drug-induced toxicity.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To develop and evaluate a risk-stratification strategy based on baseline hematologic reserve and vancomycin treatment duration.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This single-center retrospective cohort included adult inpatients receiving intravenous vancomycin for \u22653\u2009days. Patients with baseline leukopenia\/neutropenia, hematologic disease, malignancy or antitumor therapy, non-intravenous use, or unavailable blood counts were excluded. The primary endpoint was laboratory-defined leukopenia\/neutropenia, defined as new white blood cell count (WBC) <4.0\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L or absolute neutrophil count (ANC) <2.0\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L during therapy or within 3\u2009days after discontinuation. A 4-component baseline hematologic reserve score was constructed from WBC, ANC, monocyte count, and hemoglobin.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 506 patients, 75 developed leukopenia\/neutropenia, corresponding to an event rate of 14.8%. The score assigned 1 point each for WBC \u22647.77\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L, ANC \u22646.62\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L, monocyte count \u22640.40\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L, and hemoglobin \u2264102\u2009g\/L. Event rates increased from 7.5% to 40.9% across scores of 0 to 4 (\n P<\/jats:italic>\n for trend\u2009<\u2009.001), and were 8.6%, 12.2%, and 34.5% in the low-, intermediate-, and high-risk groups, respectively. Compared with the low-risk group, the score-defined high-risk group had higher odds of laboratory-defined leukopenia\/neutropenia (adjusted odds ratio [OR] 7.52, 95% CI, 3.95-14.33,\n P<\/jats:italic>\n \u2009<\u2009.001). Vancomycin duration >14\u2009days was also independently associated with the outcome (adjusted OR 5.08, 95% CI, 2.77-9.29,\n P<\/jats:italic>\n \u2009<\u2009.001). The highest risk was observed in high-risk patients treated for >14\u2009days, with an event rate of 75.0%. The baseline score model showed moderate performance (area under the curve [AUC] 0.697), whereas the extended model incorporating the score-defined risk group, treatment duration, and clinical covariates improved discrimination (AUC 0.786).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion and Relevance:<\/jats:title>\n A 4-component baseline hematologic reserve score combined with treatment duration may help identify patients who warrant closer complete blood count monitoring during vancomycin therapy. These findings should be interpreted as laboratory-event risk stratification rather than proof of definite vancomycin-induced toxicity or as a mandatory discontinuation threshold.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10600280261476308","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:27:51Z","timestamp":1787898471000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline Hematologic Reserve and Laboratory-Defined Leukopenia\/Neutropenia During Vancomycin Therapy: A Real-World Risk-Stratification Cohort Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4029-4693","authenticated-orcid":false,"given":"Dong","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second People\u2019s Hospital of Fuyang, Fuyang Infectious Disease Clinical College of Anhui Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linlin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Fuyang People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa303"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2017.1.187"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.15170"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01596-22"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1P583"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/00185787231158775"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy12010038"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26146584"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1Q467"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1086\/314028"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.81135"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.22.9.783.34059"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.727717"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2567.2008.02950.x"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1159\/000489406"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2017.10.021"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0000000000000716"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028020975646"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S544195"}],"container-title":["Annals 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