{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:58:05Z","timestamp":1785308285874,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T00:00:00Z","timestamp":1767398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objectives: This study aimed to clarify the area under the curve (AUC) for obtaining better clinical outcomes and to demonstrate vancomycin dosing for achieving the AUC in haemodialysis (HD). Methods: The vancomycin concentration was measured before the second HD. The AUC24\u201348h after the initial HD was assessed to evaluate its correlation with an early clinical response and to determine the dosing regimen, assuming an inter-dialysis interval of 48 h, even if the interval was 72 h. Results: An AUC\/MIC \u2265 400 was an independent factor for an early response in treating MRSA infections and infections caused by methicillin-resistant Gram-positive organisms. An AUC of 600\u2013700 \u03bcg\u00b7h\/mL did not increase the incidence of adverse effects compared with that of &lt;600 \u03bcg\u00b7h\/mL. An AUC of 400\u2013700 \u03bcg\u00b7h\/mL was obtained in 90.5% of patients with a loading dose of 30 mg\/kg followed by a maintenance dose of 10 mg\/kg. Pre-dialysis concentrations were significantly higher than the trough concentration required in non-HD patients to achieve the same AUC category, and AUC24\u201348h was strongly correlated with pre-dialysis concentrations (R2 = 0.921). In a receiver operating characteristic curve, the cut-off value for an early response was 16.8 \u03bcg\/mL for the pre-dialysis concentration\/MIC. Conclusions: AUC24\u201348h after the initial HD\/MIC of \u2265400 \u03bcg\/mL improves the clinical outcomes in patients on HD, and the target PK\/PD can be achieved with an upper range of the recommended dose. The pre-dialysis concentration may be a reliable surrogate for the AUC, and the vancomycin dose could be adjusted according to this PK target.<\/jats:p>","DOI":"10.3390\/antibiotics15010047","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:38:56Z","timestamp":1767616736000},"page":"47","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vancomycin Dosing Regimen to Obtain the Target Area Under the Concentration\u2013Time Curve, Which Provides an Early Treatment Response for Patients on Haemodialysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Minori","family":"Kambe","sequence":"first","affiliation":[{"name":"Department of Nephrology, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5176-9050","authenticated-orcid":false,"given":"Takashi","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, Hyogo Medical University Hospital, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, Hyogo Medical University Hospital, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naruhito","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, Hyogo Medical University Hospital, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2934-1680","authenticated-orcid":false,"given":"Motoi","family":"Uchino","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9760-0173","authenticated-orcid":false,"given":"Yuki","family":"Horio","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Toyama","sequence":"additional","affiliation":[{"name":"Pharmaceutical Department, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Tomita","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuki","family":"Ide","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuko","family":"Ao","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Nozaki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8635-6416","authenticated-orcid":false,"given":"Yoshio","family":"Takesue","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, Hyogo Medical University Hospital, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan"},{"name":"Department of Infection Prevention and Control, Chita Peninsula General Medical Organization, Rinku Hospital, 3-3-3 Asukadai, Tokoname 479-8510, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1086\/669869","article-title":"Antimicrobial use in outpatient hemodialysis units","volume":"34","author":"Snyder","year":"2013","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1007\/s11255-023-03521-4","article-title":"Methicillin-resistant Staphylococcus aureus nasal carriage among patients on haemodialysis with newly inserted central venous catheters","volume":"55","author":"Wong","year":"2023","journal-title":"Int. Urol. Nephrol."},{"key":"ref_3","unstructured":"Centers for Disease Control and Prevention (2025, August 02). Preventing Bloodstream Infections in People on Dialysis|VitalSigns|CDC, Available online: https:\/\/www.cdc.gov\/vitalsigns\/dialysis-infections\/index.html?utm_source=chatgpt.com."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1086\/502523","article-title":"Costs and outcomes among hemodialysis-dependent patients with methicillin-resistant or methicillin-susceptible Staphylococcus aureus bacteremia","volume":"26","author":"Reed","year":"2005","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Matsumoto, K., Oda, K., Shoji, K., Hanai, Y., Takahashi, Y., Fujii, S., Hamada, Y., Kimura, T., Mayumi, T., and Ueda, T. (2022). Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring. Pharmaceutics, 14.","DOI":"10.3390\/pharmaceutics14030489"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Tsutsuura, M., Moriyama, H., Kojima, N., Mizukami, Y., Tashiro, S., Osa, S., Enoki, Y., Taguchi, K., Oda, K., and Fujii, S. (2021). The monitoring of vancomycin: A systematic review and meta-analyses of area under the concentration\u2013time curve-guided dosing and trough-guided dosing. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-05858-6"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ueda, T., Takesue, Y., Nakajima, K., Ichiki, K., Ishikawa, K., Yamada, K., Doita, A., Wada, Y., Okada, M., and Hanai, Y. (2022). 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. Antibiotics, 11.","DOI":"10.3390\/antibiotics11010096"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.jiac.2024.05.014","article-title":"Validation and development of population pharmacokinetic model of vancomycin using a real-world database from a nationwide free web application","volume":"30","author":"Oda","year":"2024","journal-title":"J. Infect. Chemother."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e0008923","DOI":"10.1128\/aac.00089-23","article-title":"Model-Informed Precision Dosing of Vancomycin in Adult Patients Undergoing Hemodialysis","volume":"67","author":"Oda","year":"2023","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.1093\/jac\/dkae249","article-title":"Evaluation of target area under the concentration\u2013time curve of vancomycin in an initial dosing design: A retrospective cohort study","volume":"79","author":"Iida","year":"2024","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/jcph.1727","article-title":"Evaluation and development of vancomycin dosing schemes to meet new AUC\/MIC targets in intermittent hemodialysis using Monte Carlo simulation techniques","volume":"61","author":"Lewis","year":"2021","journal-title":"J. Clin. Pharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/1120009X.2024.2367937","article-title":"Vancomycin loading dose individualization in obese patients undergoing haemodialysis based on a population pharmacokinetic model","volume":"37","author":"Hartinger","year":"2025","journal-title":"J. Chemother."},{"key":"ref_13","first-page":"606","article-title":"Vancomycin dosing regimen by Monte Carlo simulation in patients on intermittent high-efficiency hemodialysis","volume":"98","author":"Rungprai","year":"2015","journal-title":"J. Med. Assoc. Thai."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lewis, S.J., Jang, S.M., and Mueller, B.A. (2023). Vancomycin and daptomycin dosing recommendations in patients receiving home hemodialysis using Monte Carlo simulation. BMC Nephrol., 24.","DOI":"10.1186\/s12882-023-03314-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"31220","DOI":"10.1038\/s41598-024-82587-1","article-title":"Vancomycin administration and AUC\/MIC in patients with acute kidney injury on hemodialysis: Randomized clinical trial","volume":"14","author":"Zamoner","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1177\/08971900231198927","article-title":"Development and assessment of vancomycin dosing utilizing AUC\/MIC protocol in ESRD patients on intermittent hemodialysis","volume":"37","author":"Ables","year":"2024","journal-title":"J. Pharm. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1093\/cid\/cir337","article-title":"Implementation of a dose calculator for vancomycin to achieve target trough levels of 15\u201320 \u00b5g\/mL in hemodialysis patients","volume":"53","author":"Vandecasteele","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","first-page":"130","article-title":"Optimizing vancomycin dosage regimens in relation to high-flux haemodialysis","volume":"74","author":"Hui","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Fu, C.F., Huang, J.D., Wang, J.T., Lin, S.W., and Wu, C.C. (2018). The ratio of pre-dialysis vancomycin trough serum concentration to minimum inhibitory concentration is associated with treatment outcomes in methicillin-resistant Staphylococcus aureus bacteremia. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193585"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/ajhp\/zxaa036","article-title":"Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by professional societies","volume":"77","author":"Rybak","year":"2020","journal-title":"Am. J. Health-Syst. Pharm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.34067\/KID.0000192021","article-title":"New Vancomycin Dosing Guidelines for Hemodialysis Patients: Rationale, Caveats, and Limitations","volume":"2","author":"Lewis","year":"2021","journal-title":"Kidney360"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/S0140-6736(16)30448-2","article-title":"Factors affecting outcomes in patients reaching end-stage kidney disease worldwide: Differences in access to renal replacement therapy and haemodialysis practices","volume":"388","author":"Robinson","year":"2016","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10272","DOI":"10.1038\/s41598-024-60831-y","article-title":"Current dialyzer classification in Japan and mortality risk in patients undergoing hemodialysis","volume":"14","author":"Abe","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000437405","article-title":"Clinical Expectation of Online Hemodiafiltration: A Japanese Perspective","volume":"40","author":"Akizawa","year":"2015","journal-title":"Blood Purif."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1159\/000503891","article-title":"Validity of Intermittent Infusion Hemodiafiltration","volume":"48","author":"Mineshima","year":"2019","journal-title":"Blood Purif."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s10156-013-0599-4","article-title":"Practice guidelines for therapeutic drug monitoring of vancomycin: A consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring","volume":"19","author":"Matsumoto","year":"2013","journal-title":"J. Infect. Chemother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1093\/jac\/dkq281","article-title":"Tolerability of prolonged linezolid therapy in bone and joint infection: Protective effect of rifampicin on the occurrence of anaemia","volume":"65","author":"Legout","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1007\/s10096-016-2691-z","article-title":"Enhanced loading regimen of teicoplanin is necessary to achieve therapeutic pharmacokinetic levels for the improvement of clinical outcomes in patients with renal dysfunction","volume":"35","author":"Ueda","year":"2016","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_29","unstructured":"Clinical and Laboratory Standards Institute (2018). Performance Standards for Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, CLSI. [11th ed.]. Approved Standard."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1007\/s11095-021-03030-y","article-title":"Performance of area under the concentration\u2013time curve estimations of vancomycin with limited sampling by a newly developed web application","volume":"38","author":"Oda","year":"2021","journal-title":"Pharm. Res."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/1\/47\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:30:54Z","timestamp":1767864654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/1\/47"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,3]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["antibiotics15010047"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15010047","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,3]]}}}