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The 2020 IDSA guideline recommends AUC\n                      <jats:sub>24<\/jats:sub>\n                      -based dosing for MRSA to increase treatment safety. Due to the low MRSA prevalence at the University Hospital of W\u00fcrzburg (UKW), this study investigated the impact of model-informed precision dosing (MIPD) of vancomycin on AKI incidence and target attainment in MRSA and non-MRSA infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This pre-post intervention study compared a retrospective group (January 1, 2019 - June 30, 2021) with a prospective group (October 17, 2022 - December 31, 2023), including critically ill patients from intensive and intermediate care units. The prospective group received AUC\n                      <jats:sub>24<\/jats:sub>\n                      -based MIPD using Bayesian pharmacometric modeling performed by a clinical pharmacist. The primary outcome was the incidence of AKI. Secondary outcomes included vancomycin therapeutic target attainment and the proportions of therapies within, below, and above the therapeutic range.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AKI occurred in 27.8% of the retrospective group and 14.0% of the prospective group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). The AUC-based group achieved therapeutic targets more frequently (70.2% vs. 55.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) and had fewer supratherapeutic levels (8.8% vs. 24.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      AUC\n                      <jats:sub>24<\/jats:sub>\n                      -based MIPD for vancomycin improved therapeutic target attainment and was associated with a lower observed incidence of AKI. These findings support further evaluation of AUC-guided dosing for both MRSA and non-MRSA infections.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40360-026-01224-x","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:03:38Z","timestamp":1789491818000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Model-informed AUC-guided dosing for parenteral vancomycin in critically ill patients: impact on target attainment and renal safety \u2013 a pre-post intervention study"],"prefix":"10.1186","volume":"27","author":[{"given":"Laura","family":"Gundlach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareike","family":"Kunkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Scherf-Clavel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fczin","family":"Surat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"issue":"4","key":"1224_CR1","first-page":"694","volume":"19","author":"FR Bruniera","year":"2015","unstructured":"Bruniera FR, Ferreira FM, Saviolli LR, Bacci MR, Feder D, da Luz Gon\u00e7alves Pedreira M, et al. 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The intervention consisted of the implementation of AUC-guided dosing for vancomycin, an approach supported by current clinical guidelines and included in the Summary of Product Characteristics, thus representing in-label use of the medicinal product within standard clinical practice. Ethical approval for the use of patient data was obtained from the Ethics Committee of Julius-Maximilians-University Wuerzburg (reference number: 2024012202). The requirement for obtaining individual informed consent was waived by the Ethics Committee, as the study involved no additional interventions, no direct patient contact, and only anonymized data were used for analysis.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. The manuscript does not contain any individual person\u2019s identifiable data. All data were analyzed in anonymized or pseudoanonymized form, and an ethics waiver was granted.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"128"}}