Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study
Abstract Background The impact of shortening or extending a vancomycin dosing interval on early attainment of target blood levels and acute kidney injury (AKI) remains unclear. We investigated the relationship between the interval of the first and second doses of vancomycin and early area under the...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Journal of Pharmaceutical Health Care and Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40780-025-00452-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850231384367431680 |
|---|---|
| author | Tomoyuki Ishigo Ayako Suzuki Yuta Ibe Satoshi Fujii Masahide Fukudo Hiroaki Yoshida Hiroaki Tanaka Hisato Fujihara Fumihiro Yamaguchi Fumiya Ebihara Takumi Maruyama Yukihiro Hamada Yusuke Yagi Masaru Samura Fumio Nagumo Toshiaki Komatsu Atsushi Tomizawa Akitoshi Takuma Hiroaki Chiba Yoshifumi Nishi Yuki Enoki Kazuaki Taguchi Kazuaki Matsumoto |
| author_facet | Tomoyuki Ishigo Ayako Suzuki Yuta Ibe Satoshi Fujii Masahide Fukudo Hiroaki Yoshida Hiroaki Tanaka Hisato Fujihara Fumihiro Yamaguchi Fumiya Ebihara Takumi Maruyama Yukihiro Hamada Yusuke Yagi Masaru Samura Fumio Nagumo Toshiaki Komatsu Atsushi Tomizawa Akitoshi Takuma Hiroaki Chiba Yoshifumi Nishi Yuki Enoki Kazuaki Taguchi Kazuaki Matsumoto |
| author_sort | Tomoyuki Ishigo |
| collection | DOAJ |
| description | Abstract Background The impact of shortening or extending a vancomycin dosing interval on early attainment of target blood levels and acute kidney injury (AKI) remains unclear. We investigated the relationship between the interval of the first and second doses of vancomycin and early area under the concentration-time curve (AUC) and AKI. Methods Patients (≥ 18 years) who started vancomycin and had trough/peak blood samples were included. The definition of shortened interval as the first and second doses of vancomycin was < 12 h. The cumulative incidence of AKI within 21 days was compared using the shortened interval and AUC on day 1 and 2. Results Among 668 patients (median age 69 [interquartile range (IQR): 57, 78] years, 40% female), the proportion achieving an AUC ≥ 400 µg·h/mL on day 1 was significantly higher in the shortened-interval group (82% vs. 50%; p < 0.001). Multivariate analysis revealed no association between a shortened interval (hazards ratio [HR], 1.10 [95% confidence interval (CI), 0.63–1.91]; p = 0.750) or an AUC > 600 µg·h/mL on day 1 alone (HR, 2.17 [95% CI, 0.64–7.42]; p = 0.220) and AKI onset. However, an AUC > 600 µg·h/mL on day 2 alone (HR, 2.92 [95% CI, 1.45–5.87]; p = 0.003) or on both days (HR, 11.18 [95% CI, 5.07–24.67]; p < 0.001) was significantly associated with increased AKI risk. Conclusions Shortening the dosing interval facilitates early achievement of target AUC without increasing AKI risk, provided AUC on day 2 is appropriately controlled. |
| format | Article |
| id | doaj-art-ca72f6295c754246ae9acf093928d80b |
| institution | OA Journals |
| issn | 2055-0294 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj-art-ca72f6295c754246ae9acf093928d80b2025-08-20T02:03:32ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942025-05-0111111110.1186/s40780-025-00452-3Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective studyTomoyuki Ishigo0Ayako Suzuki1Yuta Ibe2Satoshi Fujii3Masahide Fukudo4Hiroaki Yoshida5Hiroaki Tanaka6Hisato Fujihara7Fumihiro Yamaguchi8Fumiya Ebihara9Takumi Maruyama10Yukihiro Hamada11Yusuke Yagi12Masaru Samura13Fumio Nagumo14Toshiaki Komatsu15Atsushi Tomizawa16Akitoshi Takuma17Hiroaki Chiba18Yoshifumi Nishi19Yuki Enoki20Kazuaki Taguchi21Kazuaki Matsumoto22Department of Pharmacy, Sapporo Medical University HospitalLaboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato UniversityDepartment of Pharmacy, Sapporo Medical University HospitalDepartment of Pharmacy, Sapporo Medical University HospitalDepartment of Pharmacy, Sapporo Medical University HospitalDepartment of Pharmacy, Kyorin University HospitalDepartment of Pharmacy, Kyorin University HospitalDepartment of Hospital Pharmaceutics, School of Pharmacy, Showa Medical UniversityDepartment of Respiratory Medicine, Showa Medical University Fujigaoka HospitalDepartment of Pharmacy, Tokyo Women’s Medical University HospitalDepartment of Pharmacy, Kochi Medical School HospitalDepartment of Pharmacy, Tokyo Women’s Medical University HospitalDepartment of Pharmacy, Kochi Medical School HospitalDepartment of Pharmacy, Yokohama General HospitalDepartment of Pharmacy, Yokohama General HospitalDepartment of Pharmacy, Kitasato University HospitalDepartment of Pharmacy, Kitasato University HospitalDepartment of Hospital Pharmaceutics, School of Pharmacy, Showa Medical UniversityDepartment of Pharmacy, Tohoku Kosai HospitalCenter for Pharmacist Education, School of Pharmacy, Nihon UniversityDivision of Pharmacodynamics, Keio University Faculty of PharmacyDivision of Pharmacodynamics, Keio University Faculty of PharmacyDivision of Pharmacodynamics, Keio University Faculty of PharmacyAbstract Background The impact of shortening or extending a vancomycin dosing interval on early attainment of target blood levels and acute kidney injury (AKI) remains unclear. We investigated the relationship between the interval of the first and second doses of vancomycin and early area under the concentration-time curve (AUC) and AKI. Methods Patients (≥ 18 years) who started vancomycin and had trough/peak blood samples were included. The definition of shortened interval as the first and second doses of vancomycin was < 12 h. The cumulative incidence of AKI within 21 days was compared using the shortened interval and AUC on day 1 and 2. Results Among 668 patients (median age 69 [interquartile range (IQR): 57, 78] years, 40% female), the proportion achieving an AUC ≥ 400 µg·h/mL on day 1 was significantly higher in the shortened-interval group (82% vs. 50%; p < 0.001). Multivariate analysis revealed no association between a shortened interval (hazards ratio [HR], 1.10 [95% confidence interval (CI), 0.63–1.91]; p = 0.750) or an AUC > 600 µg·h/mL on day 1 alone (HR, 2.17 [95% CI, 0.64–7.42]; p = 0.220) and AKI onset. However, an AUC > 600 µg·h/mL on day 2 alone (HR, 2.92 [95% CI, 1.45–5.87]; p = 0.003) or on both days (HR, 11.18 [95% CI, 5.07–24.67]; p < 0.001) was significantly associated with increased AKI risk. Conclusions Shortening the dosing interval facilitates early achievement of target AUC without increasing AKI risk, provided AUC on day 2 is appropriately controlled.https://doi.org/10.1186/s40780-025-00452-3VancomycinTherapeutic drug monitoringDosing intervalArea under the concentration-time curveAcute kidney injury |
| spellingShingle | Tomoyuki Ishigo Ayako Suzuki Yuta Ibe Satoshi Fujii Masahide Fukudo Hiroaki Yoshida Hiroaki Tanaka Hisato Fujihara Fumihiro Yamaguchi Fumiya Ebihara Takumi Maruyama Yukihiro Hamada Yusuke Yagi Masaru Samura Fumio Nagumo Toshiaki Komatsu Atsushi Tomizawa Akitoshi Takuma Hiroaki Chiba Yoshifumi Nishi Yuki Enoki Kazuaki Taguchi Kazuaki Matsumoto Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study Journal of Pharmaceutical Health Care and Sciences Vancomycin Therapeutic drug monitoring Dosing interval Area under the concentration-time curve Acute kidney injury |
| title | Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study |
| title_full | Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study |
| title_fullStr | Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study |
| title_full_unstemmed | Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study |
| title_short | Shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target AUC without increasing the risk of acute kidney injury, provided the AUC on the second day is appropriately controlled: a multicenter retrospective study |
| title_sort | shortening the interval between the first and the second dose of vancomycin facilitates rapid achievement of the target auc without increasing the risk of acute kidney injury provided the auc on the second day is appropriately controlled a multicenter retrospective study |
| topic | Vancomycin Therapeutic drug monitoring Dosing interval Area under the concentration-time curve Acute kidney injury |
| url | https://doi.org/10.1186/s40780-025-00452-3 |
| work_keys_str_mv | AT tomoyukiishigo shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT ayakosuzuki shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT yutaibe shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT satoshifujii shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT masahidefukudo shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT hiroakiyoshida shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT hiroakitanaka shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT hisatofujihara shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT fumihiroyamaguchi shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT fumiyaebihara shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT takumimaruyama shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT yukihirohamada shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT yusukeyagi shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT masarusamura shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT fumionagumo shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT toshiakikomatsu shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT atsushitomizawa shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT akitoshitakuma shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT hiroakichiba shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT yoshifuminishi shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT yukienoki shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT kazuakitaguchi shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy AT kazuakimatsumoto shorteningtheintervalbetweenthefirstandtheseconddoseofvancomycinfacilitatesrapidachievementofthetargetaucwithoutincreasingtheriskofacutekidneyinjuryprovidedtheaucontheseconddayisappropriatelycontrolledamulticenterretrospectivestudy |