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Updated: Jun 5, 2025

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Clinical Efficacy and Safety of Vancomycin Based on Unbound Vancomycin Concentration Monitoring
Fefei Ren1, Shan Li, Yixin Liu
1The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Objective:
To monitor total trough concentration (C min_total ) and unbound trough concentration (C min_free ) of vancomycin in clinical samples and analyze the factors influencing them, and to assess their correlation with clinical efficacy and acute kidney injury (AKI).
Methods:
Plasma samples were processed by protein precipitation, followed by hollow-fiber centrifugal ultrafiltration to separate unbound vancomycin from plasma. Thereafter, C min_total and C min_free were determined using high-performance liquid chromatography. Clinical data of patients were collected. Factors affecting vancomycin C min_total , C min_free , and their correlation with clinical efficacy and nephrotoxicity were investigated.
Results:
A total of 146 samples from 105 included patients were collected. C min_total and C min_free of vancomycin ranged from 0.62 to 56.08 mcg·mL -1 and 0.61-38.51 mcg·mL -1 , respectively. C min_total and C min_free were correlated (r = 0.8899), influenced by basal creatinine and cystatin C. Higher level of C min_free (˃8.6 mcg·mL -1 ) and nephrotoxic drugs concomitant were risk factors of vancomycin-associated AKI ( P < 0.05); C min_total and C min_free thresholds of vancomycin-associated AKI were 15.35 and 6.83 mcg·mL -1 , respectively.
Conclusions:
vancomycin C min_total and C min_free , higher C min_total and C min_free were correlated and higher concentrations of both may increase the risk of AKI.
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