{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:54:12Z","timestamp":1782921252712,"version":"3.54.5"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of deviations in blood sampling time on the interpretation of measured trough concentrations in vancomycin therapeutic drug monitoring; to explore a reference time window for early blood sampling in clinical settings where trough concentration monitoring remains the primary approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 160 therapeutic drug monitoring (TDM) records from inpatients receiving vancomycin TDM in our hospital between March 2024 and March 2026. Among these, 137 early-sampled cases were included for analysis, with predicted trough concentrations (C_pred) obtained using the Pharmado platform. Using C_pred as a model-assisted reference, the relative standard deviation (RSD) of measured concentrations (C_obs) was calculated. The target range of 10\u201320\u202f\u03bcg\/mL was applied to assess misjudgments in target attainment. Spearman correlation and Logistic regression analyses were employed to evaluate the relationship between time deviation (\u0394t) and RSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      C_obs exhibited a systematic tendency toward overestimation compared to C_pred, with a significant positive correlation between \u0394t and RSD (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u202f=\u202f0.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). In the group with sampling within 1\u202fh before scheduled dosing, the median RSD was 10.8%, with 81.3% of cases meeting |RSD|\u202f\u2264\u202f20% and zero misjudgments in target attainment. For sampling 1\u20132\u202fh prior, this proportion declined to 60.0%. In the &amp;gt;2\u202fh group, it fell to less than 24.6%, with significantly elevated misjudgment risk. Logistic regression confirmed advancing sampling time negatively predicted |RSD|\u202f\u2264\u202f20% probability (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2081\u202f=\u202f\u22121.088, odds ratio\u202f=\u202f0.337). The model estimated that when blood sampling occurred approximately 0.83 and 2.10\u202fh in advance, this probability decreased to 80 and 50%, respectively; however, these time points and the \u22641\u202fh reference window should be considered exploratory findings conditional on the predictive performance of the Pharmado model and the limited sample size, and external validation is required before broader clinical application.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early blood sampling in vancomycin TDM can lead to systematic overestimation of trough concentrations, with greater deviations associated with longer early sampling times. When the blood sampling time is advanced by \u22641\u202fh, the deviation between the measured concentration and the predicted trough concentration is minimal. Under the condition that the sampling time is accurately recorded, the measured value may be cautiously used for target concentration assessment. If the sampling time falls outside this window, either platform-based correction or re-sampling is recommended. The proposed 1-h threshold should be interpreted as an exploratory, model-dependent reference rather than a definitive clinical cutoff.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1862353","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:40:58Z","timestamp":1782920458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of blood sampling time deviations on vancomycin therapeutic drug monitoring and clinical decision-making"],"prefix":"10.3389","volume":"13","author":[{"given":"Mingxin","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Affiliated Yixing Hospital of Jiangsu University","place":["Yixing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Wang","sequence":"additional","affiliation":[{"name":"Graduate school, The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Affiliated Yixing Hospital of Jiangsu University","place":["Yixing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Affiliated Yixing Hospital of Jiangsu University","place":["Yixing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Affiliated Yixing Hospital of Jiangsu University","place":["Yixing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"27165","DOI":"10.1038\/s41598-024-78558-1","article-title":"Prediction of vancomycin plasma concentration in elderly patients based on multi-algorithm mining combined with population pharmacokinetics","volume":"14","author":"Ma","year":"2024","journal-title":"Sci Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3969\/j.issn.1672-3384.2021.01.003","article-title":"Evidence-based guideline for therapeutic drug monitoring of Vancomycin: 2020 update","volume":"19","author":"He","year":"2021","journal-title":"J Clin Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1093\/jac\/dkae442","article-title":"Treatment success prediction in patients with methicillin-resistant coagulase-negative staphylococci infections, using vancomycin AUC24\/MIC ratio: a multicentre retrospective cohort study","volume":"80","author":"Hanai","year":"2025","journal-title":"J Antimicrob Chemother"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"96","DOI":"10.3390\/antibiotics11010096","article-title":"Validation of vancomycin area under the concentration\u2013time curve estimation by the Bayesian approach using one-point samples for predicting clinical outcomes in patients with methicillin-resistant Staphylococcus aureus infections","volume":"11","author":"Takashi","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"S363","DOI":"10.1093\/cid\/ciaa1536","article-title":"Evidence-based guideline for therapeutic drug monitoring of vancomycin: 2020 update by the division of therapeutic drug monitoring, Chinese pharmacological society","volume":"71","author":"He","year":"2020","journal-title":"Clin Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.19803\/j.1672-8629.20210812","article-title":"Correlations between vancomycin administration regimen recommended by the guidelines and blood trough concentrations","volume":"19","author":"Duan","year":"2022","journal-title":"Chin J Pharmacovigil"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"293","DOI":"10.16343\/j.cnki.issn.2095-512x.2024.03.001","article-title":"Factors influencing vancomycin trough concentration and construction of multiple linear regression model","volume":"46","author":"Wang","year":"2024","journal-title":"J Inner Mongolia Med Univ"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2822","DOI":"10.6039\/j.issn.1001-0408.2025.22.12","article-title":"Comparison of predictive accuracy and clinical applicability among four vancomycin individualized dosing tools","volume":"36","author":"Chen","year":"2025","journal-title":"China Pharm"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"783.e7","DOI":"10.1016\/j.cmi.2020.07.005","article-title":"Towards precision dosing of vancomycin in critically ill patients: an evaluation of the predictive performance of pharmacometric models in ICU patients","volume":"27","author":"Cunio","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"ejhpharm-2025-004590","DOI":"10.1136\/ejhpharm-2025-004590","article-title":"Impact of using different renal function estimation equations on vancomycin dosing","author":"Gratac\u00f3s","year":"2025","journal-title":"Eur J Hosp Pharm"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1007\/s00228-021-03215-9","article-title":"The pharmacokinetics of tacrolimus in peripheral blood mononuclear cells and limited sampling strategy for estimation of exposure in renal transplant recipients","volume":"78","author":"Wang","year":"2022","journal-title":"Eur J Clin Pharmacol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1007\/s11095-024-03728-9","article-title":"Predictive value of vancomycin AUC24\/MIC ratio for 30-day mortality in patients with severe or complicated methicillin-resistant Staphylococcus aureus infections: a multicenter retrospective study","volume":"41","author":"Hanai","year":"2024","journal-title":"Pharm Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s11096-024-01822-x","article-title":"Model-informed precision dosing of vancomycin in clinical practice: an intervention development study","volume":"47","author":"Swartling","year":"2025","journal-title":"Int J Clin Pharm"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1862353\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:41:03Z","timestamp":1782920463000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1862353\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":13,"alternative-id":["10.3389\/fmed.2026.1862353"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1862353","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"article-number":"1862353"}}