Validation of Vancomycin Area under the Concentration—Time Curve Estimation by the Bayesian Approach Using One-Point Samples for Predicting Clinical Outcomes in Patients with Methicillin-Resistant <i>Staphylococcus aureus</i> Infections

Abstract

Area under the concentration–time curve (AUC)-guided vancomycin treatment is associated with decreased nephrotoxicity. It is preferable to obtain two samples to estimate the AUC. This study examined the usefulness of AUC estimation via trough concentration (Cmin)-only sampling of 260 adults infected with methicillin-resistant Staphylococcus aureus (MRSA) who received vancomycin. The exact Cmin sampling time was used for Bayesian estimation. A significantly higher early treatment response was observed in patients with a day 2 AUC ≥ 400 µg·h/mL than those with min measurement. However, assessment with two samples might be required in patients with q24 administration or high/moderate-risk MRSA infections.

Keywords

• vancomycin
• area under the concentration–time curve
• Bayesian estimation
• methicillin-resistant <i>Staphylococcus aureus</i> infection
• nephrotoxicity