Rates of Acute Kidney Injury Utilizing Area Under the Concentration–Time Curve Versus Trough-Based Vancomycin Dosing Strategies in Patients With Obesity

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AUC-based vancomycin dosing in obese patients resulted in a significantly lower incidence of acute kidney injury compared to trough-based dosing.
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The study included 398 obese patients treated with vancomycin for severe MRSA infections, with 230 in the trough group and 168 in the AUC group.
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AKI rates were 11.3% in the AUC group versus 25.2% in the trough group, indicating a substantial reduction with AUC dosing.
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AUC-based dosing also achieved higher initial target attainment rates at 50.0% compared to 23.9% for trough-based dosing.
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The findings support the shift to AUC-guided vancomycin dosing in obese patients to minimize nephrotoxicity and improve therapeutic outcomes.

Open Forum Infectious Diseases

by Corey M Guidry, Emily A Siegrist, Stephen B Neely, Lyndee Springer, Bryan P White
April 3, 2025

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