Rates of Acute Kidney Injury Utilizing Area Under the Concentration–Time Curve Versus Trough-Based Vancomycin Dosing Strategies in Patients With Obesity - Summary - MDSpire
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Rates of Acute Kidney Injury Utilizing Area Under the Concentration–Time Curve Versus Trough-Based Vancomycin Dosing Strategies in Patients With Obesity
To evaluate the incidence of acute kidney injury (AKI) in obese patients receiving vancomycin after switching from trough-based to AUC-guided dosing, specifically comparing the two dosing strategies.
Key Findings:
AKI rates were significantly lower in the AUC group (11.3%) compared to the trough group (25.2%), P < .001.
Logistic regression showed a reduction in AKI with AUC dosing for cumulative doses less than the median of 10,250 mg, OR 0.47 (95% CI, .25–.88).
Initial target attainment rates were higher in the AUC group (50.0% vs 23.9%, P < .001).
Interpretation:
AUC-guided vancomycin dosing in obese patients is associated with lower rates of AKI and higher target attainment compared to trough-based dosing.
Limitations:
Single-center study may limit generalizability; results may not apply to other settings.
Retrospective design may introduce selection bias, affecting the reliability of the findings.
Conclusion:
AUC-based dosing of vancomycin in obese patients reduces the incidence of AKI and improves therapeutic target attainment compared to traditional trough-based dosing.
