Association between Augmented Renal Clearance and Inadequate Vancomycin Pharmacokinetic/Pharmacodynamic Targets in Chinese Adult Patients: A Prospective Observational Study
Jinjin Zhao,
Yaxin Fan,
Minjie Yang,
Xiaoyu Liang,
Jufang Wu,
Yuancheng Chen,
Beining Guo,
Huifang Zhang,
Ruilan Wang,
Fengying Zhang,
Jingqing Hang,
Huayin Li,
Jing Zhang
Affiliations
Jinjin Zhao
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Yaxin Fan
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Minjie Yang
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Xiaoyu Liang
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Jufang Wu
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Yuancheng Chen
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Beining Guo
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
Huifang Zhang
Emergency and Critical Care Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
Ruilan Wang
Emergency and Critical Care Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
Fengying Zhang
Department of Pulmonary Medicine, Shanghai Putuo District People′s Hospital, Shanghai 200060, China
Jingqing Hang
Department of Pulmonary Medicine, Shanghai Putuo District People′s Hospital, Shanghai 200060, China
Huayin Li
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Jing Zhang
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
This study aimed to examine the risk factors of augmented renal clearance (ARC) and the association between ARC and vancomycin pharmacokinetic/pharmacodynamic (PK/PD) indices in Chinese adult patients. A prospective, observational, multicenter study was conducted, and 414 adult patients undergoing vancomycin therapeutic drug monitoring (TDM) were enrolled. Clinical and PK/PD data were compared between ARC and non-ARC groups. Independent risk factors were examined using a multivariate logistic regression analysis. The ARC and augmented renal clearance in trauma intensive care (ARCTIC) scoring systems were evaluated. Eighty-eight of the enrolled patients (88/414, 21.3%) had ARC before vancomycin therapy. Patients with ARC were more likely to have subtherapeutic vancomycin PK/PD indices, including trough concentration (p = 0.003) and 24 h area under the concentration–time curve (AUC24) to minimal inhibitory concentration (MIC) ratio (p 24/MIC; therefore, higher than routine doses may be needed. Risk factors and ARC risk scoring systems are valuable for early identification.
