Does contemporary vancomycin dosing achieve therapeutic targets in a heterogeneous clinical cohort of critically ill patients? Data from the multinational DALI study

Blot, Stijn; Koulenti, Despoina; Akova, Murat; Bassetti, Matteo; De Waele, Jan J; Dimopoulos, George; Kaukonen, Kirsi-Maija; Martin, Claude; Montravers, Philippe; Rello, Jordi; Rhodes, Andrew; Starr, Therese; Wallis, Steven C; Lipman, Jeffrey; Roberts, Jason A

doi:10.1186/cc13874

Critical Care

Table 3 Unadjusted relationships with AUC _0–24 /MIC ratio >400 and target trough concentrations (>15 mg/L)

From: Does contemporary vancomycin dosing achieve therapeutic targets in a heterogeneous clinical cohort of critically ill patients? Data from the multinational DALI study

Variable	Unadjusted relationships with AUC_0–24/MIC ratio >400		Unadjusted relationships with C_min>15 mg/L
	OR (95% CI)	P	OR (95% CI)	P
Age (/year increase)	0.99 (0.95 - 1.03)	0.547	0.99 (0.96 - 1.03)	0.723
Male sex	0.59 (0.13 - 2.69)	0.499	1.20 (0.33 - 4.32)	0.780
SOFA score (/point increase)	1.10 (0.91 - 1.32)	0.318	1.05 (0.91 - 1.21)	0.519
Renal replacement therapy	3.64 (0.40 - 33.12)	0.252	3.29 (0.59 - 18.3)	0.173
Fluid balance of the latest 24 hours
Negative fluid balance	2.20 (0.49 - 9.88)	0.305	1.12 (0.32 - 3.91)	0.856
Negative fluid balance >1000 mL	2.40 (0.26 - 22.55)	0.444	1.00 (0.19 - 5.15)	0.999
Positive fluid balance	0.46 (0.10 - 2.05)	0.305	0.89 (0.26 - 3.10)	0.856
Positive fluid balance >1000 mL	0.46 (0.11 - 1.85)	0.273	0.75 (0.22 - 2.60)	0.650
Positive fluid balance >2000 mL	0.23 (0.05 - 1.06)	0.059	0.68 (0.16 - 2.85)	0.602
Serum creatinine, mg/dL (/mg increase)	1.02 (0.71 - 1.48)	0.914	2.71 (0.78 - 9.37)	0.116
Creatinine clearance, mL/min. (/mL increase)	1.02 (0.99 - 1.04)	0.194	1.00 (0.98 - 1.01	0.457
Infection source pneumonia or intra-abdominal infection	2.84 (0.52 - 15.47)	0.227	4.2 (0.97 - 18.53)	0.056
Vancomycin dose, mg/kg (/mg increase)	1.03 (0.97 - 1.10)	0.319	1.06 (0.99 - 1.14)	0.071
Continuous infusion of vancomycin	11.00 (1.98 - 61.26)	0.006	3.82 (1.05 - 13.91)	0.042
Length of vancomycin therapy at sampling date
Days (/day increase)	1.35 (1.02 - 1.79)	0.034	0.94 (0.82 - 1.08)	0.370
>2 days	10.50 (1.88 - 58.62)	0.007	1.56 (0.45 - 5.41)	0.487
>3 days	9.00 (1.63 - 49.76)	0.012	1.30 (0.38 - 4.49)	0.687

AUC_0–24/MIC, ratio of the area under the concentration-time curve over a 24-hour period divided by the minimum inhibitory concentration of the suspected bacteria; C_min, minimum concentration of drug observed during the dosing period; OR, odds ratio; CI, confidence interval; SOFA, sequential organ failure assessment.

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