TY  - CHAP
M1  - Book, Section
TI  - Clinical Pharmacokinetics and Pharmacodynamics
A1  - Bauer, Larry A.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
PY  - 2017
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Content  UpdateOctober  1,  2019Vancomycin  Area  Under  the  Concentration-Time  Curve  Threshold  Associated  with  Nephrotoxicity:  Vancomycin  remains  a  mainstay  of  treatment  for  methicillin-resistant  Staphylococcus  aureus  (MRSA)  infection.  Because  of  the  high  mortality  rate  associated  with  MRSA  infections,  clinicians  target  higher  vancomycin  trough  concentrations  (15-20  mg/L)  to  attain  the  optimal  efficacy  target  of  area  under  the  curve  to  minimum  inhibitory  concentration  ratio  (AUC/MIC)  ≥  400.  However,  a  vancomycin  trough  concentration  >15  mg/L  increases  the  risk  of  nephrotoxicity.  AUC  has  been  identified  as  a  better  predictor  of  vancomycin-induced  nephrotoxicity.  Recent  studies  analyzed  the  relationship  between  vancomycin  AUCs  and  risk  of  nephrotoxicity  using  the  Bayesian  method.  An  AUC  <650  mg*h/L  is  suggested  as  an  acceptable  threshold  of  vancomycin  nephrotoxicity  in  both  adults  and  pediatric  patients.  Proposed  vancomycin  dosing  guidelines  recommend  AUC/MIC  of  400-600  assuming  a  vancomycin  MIC  of  ≤1  mg/L  as  new  pharmacokinetic-pharmacodynamic  (PK/PD)  target  for  maximal  efficacy  and  minimal  nephrotoxicity  in  patients  with  MRSA  infections.  AUC-guided  vancomycin  dosing  may  need  the  utilization  of  Bayesian  software  programs.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1167753172
ER  -