Vancomycin Trough Near 15.9 mg/L Flags Nephrotoxicity Risk
This large multicenter Chinese cohort offers a pragmatic trough-based risk threshold and risk-factor map for pharmacists in settings where AUC-guided monitoring is not yet routine.
vancomycinpiperacillin-tazobactamglycopeptideacute kidney injurynephrotoxicitytherapeutic drug monitoringtrough concentrationKDIGOretrospective cohortpharmacokineticsPharmacokinetics / TDM
Background Information
Vancomycin trough over 15.9 mg/L linked to kidney injury.
Vancomycin-associated acute kidney injury (VA-AKI) is a significant safety concern that affects treatment outcomes. VA-AKI occurred in 22.1% of patients; a vancomycin trough concentration of 15.9 mg/L was significantly associated with increased VA-AKI risk. The study suggests using a trough concentration of 15.9 mg/L as a threshold for VA-AKI risk, assisting clinicians when AUC-guided monitoring is unavailable. Vancomycin troughs of 15.9 mg/L may indicate a higher risk for acute kidney injury.
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Authors:Chen S, Zhang Y, Hou X, Wang Y, Zuo C, Huang C, Xia X, Cao C, Lv Q, Li X, Pan K
Citation:Chen S, Zhang Y, Hou X, et al. Risk Stratification for Vancomycin-Associated Acute Kidney Injury in Chinese Adult Inpatients: A Multicenter Retrospective Cohort Study. Infection and drug resistance. 2026;19:618586. doi:10.2147/IDR.S618586
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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