The Serum Concentration of Vancomycin as a Diagnostic Predictor of Nephrotoxic Acute Kidney Injury in Critically Ill Patients

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dc.contributor.authorZamoner, Welder [UNESP]
dc.contributor.authorEid, Karina Zanchetta Cardoso [UNESP]
dc.contributor.authorde Almeida, Lais Maria Bellaver [UNESP]
dc.contributor.authorPierri, Isabella Gonçalves [UNESP]
dc.contributor.authorDos Santos, Adriano
dc.contributor.authorBalbi, André Luis [UNESP]
dc.contributor.authorPonce, Daniela [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionBotucatu School of Medicine
dc.date.accessioned2022-04-28T19:49:45Z
dc.date.available2022-04-28T19:49:45Z
dc.date.issued2022-01-01
dc.description.abstractThe impact of serum concentrations of vancomycin is a controversial topic. Results: 182 critically ill patients were evaluated using vancomycin and 63 patients were included in the study. AKI occurred in 44.4% of patients on the sixth day of vancomycin use. Vancomycin higher than 17.53 mg/L between the second and the fourth days of use was a predictor of AKI, preceding AKI diagnosis for at least two days, with an area under the curve of 0.806 (IC 95% 0.624–0.987, p = 0.011). Altogether, 46.03% of patients died, and in the Cox analysis, the associated factors were age, estimated GFR, CPR, and vancomycin between the second and the fourth days. Discussion: The current 2020 guidelines recommend using Bayesian-derived AUC monitoring rather than trough concentrations. However, due to the higher number of laboratory analyses and the need for an application to calculate the AUC, many centers still use therapeutic trough levels between 15 and 20 mg/L. Conclusion: The results of this study suggest that a narrower range of serum concentration of vancomycin was a predictor of AKI in critically ill septic patients, preceding the diagnosis of AKI by at least 48 h, and it can be a useful monitoring tool when AUC cannot be used.en
dc.description.affiliationBotucatu School of Medicine University São Paulo State—UNESP, SP
dc.description.affiliationClinics Hospital Pharmacy Botucatu School of Medicine, SP
dc.description.affiliationUnespBotucatu School of Medicine University São Paulo State—UNESP, SP
dc.identifierhttp://dx.doi.org/10.3390/antibiotics11010112
dc.identifier.citationAntibiotics, v. 11, n. 1, 2022.
dc.identifier.doi10.3390/antibiotics11010112
dc.identifier.issn2079-6382
dc.identifier.scopus2-s2.0-85123236799
dc.identifier.urihttp://hdl.handle.net/11449/223300
dc.language.isoeng
dc.relation.ispartofAntibiotics
dc.sourceScopus
dc.subjectAcute kidney injury
dc.subjectNephrotoxicity
dc.subjectSepsis
dc.subjectVancomycin
dc.titleThe Serum Concentration of Vancomycin as a Diagnostic Predictor of Nephrotoxic Acute Kidney Injury in Critically Ill Patientsen
dc.typeArtigo

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