Related Experiment Video
Updated: Aug 14, 2026
11:28
A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
Published on: September 9, 2015
Bayesian-Estimated Vancomycin AUC24 as a Near-Term Renal Risk Signal after Therapeutic Drug Monitoring: A Multicenter
Tran Van Anh1,2, Bui Thi Tham1, Tran Thi Ngan1,2
1Faculty of Pharmacy, Hai Phong University of Medicine and Pharmacy, Hai Phong, Viet Nam.
Journal of Clinical Pharmacology
|August 12, 2026
Summary
Bayesian-estimated vancomycin area under the curve (AUC) may signal near-term kidney risk, integrating drug exposure with changing renal function, rather than indicating a direct toxicity threshold.
Area of Science:
- Pharmacology
- Nephrology
- Clinical Pharmacy
Background:
- Vancomycin dosing increasingly uses area under the concentration-time curve (AUC)-guided strategies.
- The clinical significance of Bayesian-estimated AUC, especially with changing renal function, requires clarification.
Purpose of the Study:
- To investigate the association between Bayesian-estimated 24-hour vancomycin AUC (AUC24) and acute kidney injury (AKI).
- To determine if AUC24 serves as a standalone threshold for vancomycin toxicity.
Main Methods:
- Retrospective multicenter cohort study of 898 adult vancomycin monitoring episodes in Vietnam (2019-2025).
- AUC24 estimated using institutional Bayesian software (SmartDoseAI); pharmacokinetic cross-check with BestDose.
- Acute kidney injury (AKI) assessed within 48 hours of monitoring.
Main Results:
- 9.4% of episodes (84/898) developed AKI.
- Higher continuous AUC24 showed a modest association with AKI (OR 1.16; P=.023) in initial analysis.
- Association attenuated after excluding potential pre-existing AKI and no distinct nonlinear threshold was identified.
Conclusions:
- Bayesian-estimated AUC24 may function as a near-term renal risk indicator, reflecting integrated vancomycin exposure and renal clearance.
- AUC24 is likely more valuable as a dynamic risk signal than a fixed toxicity threshold.
Related Concept Videos
01:20Estimation of k and VD of Aminoglycosides
Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:27Pharmacodynamic Models: Overview
Pharmacodynamic (PD) responses describe the interaction between a drug and its biological target, culminating in a physiological effect. These responses can be classified into different types: continuous variables, such as blood glucose levels; categorical outcomes, like survival rates; and time-to-event metrics, such as disease progression. Understanding and modeling PD responses are critical for optimizing drug efficacy and safety.PD models describe the relationship between drug concentration...
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...