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Vancomycin Dosing - The Ultimate List of Vancomycin AUC Resources & Literature

This AUC-based monitoring of vancomycin literature review summarizes research evaluating AUC-dosing strategies shown to enhance patient outcomes, reduce adverse drug events and lower healthcare costs. It is intended to serve as a reference point for pharmacists looking for trustworthy and credible literature on this topic.

Enhanced Outcomes

Research articles regarding enhanced outcomes associated with AUC-based monitoring of vancomycin.

Increased proportion of patients in the therapeutic range/AUC

Are vancomycin trough concentrations adequate for optimal dosing? 
Authors: Neely MN, Youn G, Jones B, et al. | Download Paper

Are vancomycin trough concentrations of 15 to 20 mg/L associated with increased attainment of an AUC/MIC ≥ 400 in patients with presumed MRSA infection? 
Authors: Hale CM, Seabury RW, Steele JM, Darko W, Miller CD. | Download Paper

Association between the AUC0-24/MIC ratio of vancomycin and its clinical effectiveness: a systematic review and meta-analysis.
Authors: Men P, Li HB, Zhai SD, Zhao RS. | Download Paper

Increased proportion of pediatric patients in therapeutic range/AUC

Improved vancomycin dosing in children using area under the curve exposure.
Authors: Le J, Bradley JS, Murray W, et al. | Download Paper

Early bayesian dose adjustment of vancomycin continuous infusion in children: a randomized controlled trial.
Authors: Berthaud R, Benaboud S, Hirt D, et al. | Download Paper

Bayesian clinical decision support-guided versus clinician-guided vancomycin dosing in attainment of targeted pharmacokinetic parameters in a pediatric population.
Authors: Hughes DM, Goswami S, Keizer RJ, Hughes MA, Faldasz JD. | Download Paper

Clinical and bacteriological response to vancomycin shown superior in patients with higher AUC24/MIC values

Pharmacodynamics of vancomycin and other antimicrobials in patients with Staphylococcus aureus lower respiratory tract infections.
Authors: Moise-Broder PA, Forrest A, Birmingham MC, Schentag JJ. | Download Paper

Optimal vancomycin dosing in obese patients without renal impairment

Population pharmacokinetics of vancomycin in obesity: finding the optimal dose for (morbidly) obese individuals.
Authors: Smit C, Wasmann RE, Goulooze SC, et al. | Download Paper

AUC-based targeting reduces vancomycin exposure in patients with class III obesity

An AUC target simulation for vancomycin in patients with class III obesity.
Authors: Langton MM, Ahern JW, MacDougall J. | Download Paper

Trough monitoring results in greater vancomycin exposure compared to AUC/MIC monitoring.

Examining the relationship between vancomycin area under the concentration time curve and serum trough levels in adults with presumed or documented Staphylococcal infections.
Authors: Clark L, Skrupky LP, Servais R, Brummitt CF, Dilworth TJ. | Download Paper

AUC-based monitoring results in fewer dose adjustments

The impact of AUC-based monitoring on pharmacist-directed vancomycin dose adjustments in complicated Methicillin-resistant Staphylococcus aureus infection.
Authors: Stoessel AM, Hale CM, Seabury RW, Miller CD, Steele JM. | Download Paper

Peak-trough based therapeutic drug monitoring improves vancomycin exposure

Clinical and pharmacokinetic outcomes of peak-trough-based versus trough-based vancomycin therapeutic drug monitoring approaches: a pragmatic randomized controlled trial.
Authors: Al-Sulaiti FK, Nader AM, Saad MO, et al. | Download Paper

Reduced mortality for patients with Staphylococcus aureus bacteremia

Vancomycin AUC/MIC ratio and 30-day mortality in patients with Staphylococcus aureus bacteremia.
Authors: Holmes NE, Turnidge JD, Munckhof WJ, et al. | Download Paper

Vancomycin trough concentration as a predictor of clinical outcomes in patients with Staphylococcus aureus bacteremia: a meta-analysis of observational studies. 
Authors: Prybylski JP. | Download Paper

Pharmacokinetic modelling for vancomycin

Vancomycin pharmacokinetics throughout life: results from a pooled population analysis and evaluation of current dosing recommendations.
Authors: Colin PJ, Allegaert K, Thomson AH, Touw DJ, Dolton M, de Hoog M, et al. | Download Paper

Towards precision dosing of vancomycin: a systematic evaluation of pharmacometric models for Bayesian forecasting.
Authors: Broeker A, Nardecchia M, Klinker KP, Derendorf H, Day RO, Marriott DJ, et al. | Download Paper

Vancomycin: we can’t get there from here.
Authors: Patel N, Pai MP, Rodvold KA, Lomaestro B, Drusano GL, Lodise TP. | Download Paper

Comparison of the area-under-the-curve for vancomycin estimated using compartmental and non-compartmental methods in adult patients with normal renal function.
Authors: Shingde RV, Graham GG, Reuter SE, Carland JE, Day RO, Stocker SL. | Download Paper

The dosing and monitoring of vancomycin: what is the best way forward?
Authors: Drennan PG, Begg EJ, Gardiner SJ, Kirkpatrick CMJ, Chambers ST. | Download Paper

Reduce Adverse Events

Research articles regarding decreased risk of nephrotoxicity associated with AUC-based monitoring of vancomycin.

Vancomycin area under the curve and acute kidney injury: a meta-analysis.
Authors: Aljefri DM, Avedissian SN, Rhodes NJ, Postelnick MJ, Nguyen K, Scheetz MH. | Download Paper

The impact of vancomycin area under the concentration-time curve-guided dosing on vancomycin-associated nephrotoxicity: a quasi-experiment.
Authors: Finch NA, Zasowski EJ, Murray KP, et al. | Download Paper

Reduce Costs

AUC-guided vancomycin dosing has the potential for substantial cost savings due to associations with decreased nephrotoxicity, reduced per-patient blood sampling and decreased length of therapy.

AUC24 Vancomycin Bayesian-based dosing: Increasing Therapeutic Target Attainment with Decreased Monitoring Costs  
Authors: Sabourenkov P, McLeay R. | Download Paper

Prospective trial on the use of trough concentration versus area under the curve to determine therapeutic vancomycin dosing. 
Authors: Neely MN, Kato L, Youn G, et al. | Download Paper

Implementation

Research articles regarding the implementation of AUC-based monitoring of vancomycin.

Vancomycin area under the curve dosing and monitoring at an academic medical center: transition strategies and lessons learned.
Authors: Gregory ER, Burgess DR, Cotner SE, et al. | Download Paper

Readiness to implement vancomycin monitoring based on area under the concentration-time curve: a cross-sectional survey of a national health consortium.
Authors: Kufel WD, Seabury RW, Mogle BT, Beccari MV, Probst LA, Steele JM. | Download Paper

Conversion from vancomycin trough concentration-guided dosing to area under the curve-guided dosing using two sample measurements in adults: implementation at an academic medical center.
Authors: Meng L, Wong T, Huang S, et al. | Download Paper

Challenges

Research articles regarding the challenges associated with AUC-based monitoring of vancomycin.

Appropriateness of basing vancomycin dosing on area under the concentration-time curve.
Authors: Dalton BR, Dersch-Mills D, Langevin A, Sabuda D, Rennert-May E, Greiner T. | Download Paper

Vancomycin area under the curve to minimum inhibitory concentration ratio predicting clinical outcome: a systematic review and meta-analysis with pooled sensitivity and specificity.
Authors: Dalton BR, Rajakumar I, Langevin A, et al. | Download Paper

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