{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:23:44Z","timestamp":1783470224754,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82204467"],"award-info":[{"award-number":["82204467"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2021QD033"],"award-info":[{"award-number":["2021QD033"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["SHDC12020106"],"award-info":[{"award-number":["SHDC12020106"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["BCF-XC-SQ-20221206-07"],"award-info":[{"award-number":["BCF-XC-SQ-20221206-07"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Startup Fund of Huashan Hospital, Fudan University","award":["82204467"],"award-info":[{"award-number":["82204467"]}]},{"name":"Research Startup Fund of Huashan Hospital, Fudan University","award":["2021QD033"],"award-info":[{"award-number":["2021QD033"]}]},{"name":"Research Startup Fund of Huashan Hospital, Fudan University","award":["SHDC12020106"],"award-info":[{"award-number":["SHDC12020106"]}]},{"name":"Research Startup Fund of Huashan Hospital, Fudan University","award":["BCF-XC-SQ-20221206-07"],"award-info":[{"award-number":["BCF-XC-SQ-20221206-07"]}]},{"name":"Municipal Hospital Emerging Frontier Technology Joint Research Project of Shanghai Shenkang Development Center","award":["82204467"],"award-info":[{"award-number":["82204467"]}]},{"name":"Municipal Hospital Emerging Frontier Technology Joint Research Project of Shanghai Shenkang Development Center","award":["2021QD033"],"award-info":[{"award-number":["2021QD033"]}]},{"name":"Municipal Hospital Emerging Frontier Technology Joint Research Project of Shanghai Shenkang Development Center","award":["SHDC12020106"],"award-info":[{"award-number":["SHDC12020106"]}]},{"name":"Municipal Hospital Emerging Frontier Technology Joint Research Project of Shanghai Shenkang Development Center","award":["BCF-XC-SQ-20221206-07"],"award-info":[{"award-number":["BCF-XC-SQ-20221206-07"]}]},{"name":"Community infectious disease research capacity building project","award":["82204467"],"award-info":[{"award-number":["82204467"]}]},{"name":"Community infectious disease research capacity building project","award":["2021QD033"],"award-info":[{"award-number":["2021QD033"]}]},{"name":"Community infectious disease research capacity building project","award":["SHDC12020106"],"award-info":[{"award-number":["SHDC12020106"]}]},{"name":"Community infectious disease research capacity building project","award":["BCF-XC-SQ-20221206-07"],"award-info":[{"award-number":["BCF-XC-SQ-20221206-07"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Elderly patients (age \u2265 65 years) are susceptible to methicillin-resistant Staphylococcus aureus (MRSA) infections, with potential for more adverse treatment outcomes or complications compared to younger adults (18\u201364 years). This study compared vancomycin-associated nephrotoxicity and efficacy in elderly and adult patients and investigated the correlation between vancomycin pharmacokinetic\/pharmacodynamic (PK\/PD) indices and clinical outcomes. A prospective study was conducted in 10 hospitals in Shanghai from October 2012 to November 2019. A total of 164 patients with MRSA infections were enrolled, including 83 elderly and 81 adult patients. Vancomycin therapeutic drug monitoring (TDM) was performed in all patients, indicating significantly higher vancomycin trough concentrations (Ctrough), 24-h area under the curve (AUC24) values, and AUC24\/minimum inhibitory concentration (AUC24\/MIC) values in elderly patients compared to adult patients. The incidence of vancomycin-associated nephrotoxicity was nearly three times higher in elderly patients (18.1% vs. 6.2%, p = 0.020), despite similar clinical and microbiological efficacy. Of particular importance, a Ctrough &gt; 20 mg\/L was found as an independent factor of nephrotoxicity in elderly patients. Further analysis of patients with an estimated glomerular filtration rate (eGFR) &gt; 60 mL\/min\/1.73 m2 also revealed that elderly patients had significantly higher vancomycin-related PK\/PD indices and more nephrotoxicity than adult patients. In conclusion, elderly patients receiving vancomycin therapy face a higher risk of nephrotoxicity, which requires close vancomycin TDM, especially when the Ctrough exceeds 20 mg\/L.<\/jats:p>","DOI":"10.3390\/antibiotics13040324","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T08:42:34Z","timestamp":1712133754000},"page":"324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Age-Related Differences in Vancomycin-Associated Nephrotoxicity and Efficacy in Methicillin-Resistant Staphylococcus aureus Infection: A Comparative Study between Elderly and Adult Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0353-1697","authenticated-orcid":false,"given":"Lin","family":"Xi","sequence":"first","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China"},{"name":"Key Laboratory of 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