Association between ratio of area under the concentration-time curve to minimum inhibitory concentration of vancomycin and clinical outcomes in Enterococcus faecium bacteremia

被引:2
|
作者
Komatsu, Toshiaki [1 ]
Naito, Ayama [2 ]
Akamada, Yuto [2 ]
Nihonyanagi, Shin [3 ]
Otori, Katsuya [1 ,2 ]
机构
[1] Kitasato Univ Hosp, Dept Pharm, 1-15-1 Kitasato,Minami Ku, Sagamihara, Kanagawa 2520375, Japan
[2] Kitasato Univ, Res & Educ Ctr Clin Pharm, Pharm Practice & Sci 1, Sch Pharm, 1-15-1 Kitasato,Minami Ku, Sagamihara, Kanagawa 2520375, Japan
[3] Kitasato Univ Hosp, Dept Clin Lab, 1-15-1 Kitasato,Minami Ku, Sagamihara, Kanagawa 2520375, Japan
关键词
Vancomycin; Enterococcus faecium; AUC/MIC; BLOOD-STREAM INFECTIONS; HOSPITALS; RESISTANT;
D O I
10.1016/j.jiac.2023.07.010
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The purpose of this study was to evaluate the relationship between the treatment resolution of Enterococcus faecium bacteremia and the pharmacodynamic targets of vancomycin. This is a retrospective single-center cohort study involving patients with E. faecium bacteremia on vancomycin therapy hospitalized between January 2010 and December 2021. The average vancomycin area under the concentration-time curve (AUC)(0 -24) was computed using the Bayesian approach. The minimum inhibitory concentration (MIC) was determined using the broth microdilution method, and The AUC(24)/MIC value over the initial 24-48 h of therapy was calculated. We assessed 30-day mortality, as the primary outcome. Classification and regression tree analysis (CART) was used to identify the vancomycin AUC(24)/MIC target associated with 30-day mortality. Eighty-seven patients with E. faecium bacteremia were included in this study, with 14 (16.1%) being non-survivors. In the CART analysis, vancomycin AUC/MIC >= 414.3 was associated with a higher treatment success. In multivariate analysis, an AUC/MIC >= 414.3 was a significant factor for treatment success (adjusted odds ratio = 17.5, 95% confidence interval, 3.7-83.9). Our findings suggest that a target vancomycin AUC/MIC >= 414.3 is a good prognostic indicator and could be useful for treatment monitoring of E. faecium bacteremia.
引用
收藏
页码:1181 / 1184
页数:4
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