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Associations Between Vancomycin Exposure and Acute Kidney Injury Within the Recommended Area Under the Curve

Thomas P Lodise1, Marc Scheetz2, Joseph J Carreno1

  • 1Albany College of Pharmacy and Health Sciences, Albany, New York, USA.

Open Forum Infectious Diseases
|January 26, 2022
PubMed

Insights

Vancomycin-associated acute kidney injury in patients with methicillin-resistant Staphylococcus aureus bacteremia increased with higher day 2 area under the curve (AUC). Further research is needed to assess if lower AUCs maintain treatment effectiveness.

Area of Science:

  • Pharmacology and Infectious Diseases
  • Nephrology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious infection.
  • Vancomycin is a primary treatment for MRSA, but kidney injury is a known complication.

Purpose of the Study:

  • To investigate the relationship between vancomycin exposure and acute kidney injury (AKI) in MRSA bacteremia patients.
  • To determine if vancomycin's area under the curve (AUC) is associated with AKI within the recommended therapeutic range.

Main Methods:

  • Retrospective analysis of patients with MRSA bacteremia treated with vancomycin.
  • Correlation of day 2 vancomycin AUC with the incidence of acute kidney injury.

Main Results:

  • Vancomycin-associated AKI increased with higher day 2 AUC.
  • AKI risk was elevated even for AUCs within the 400-600 range.

Conclusions:

  • Vancomycin AUC is a significant factor in AKI development for MRSA bacteremia.
  • Lowering vancomycin AUC may reduce AKI risk, but efficacy at AUCs <400 requires further investigation.
Keywords:
MRSAoutcomespharmacokineticsvancomycin

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