Evaluating Vancomycin Supratherapeutic Dosing and Associated Acute Kidney Injury: A Novel Correlation Factor Equation Applied in an Antimicrobial Stewardship Program

Abstract

This study evaluates the relationship between vancomycin supratherapeutic dosing and acute kidney injury (AKI) through a novel correlation factor equation within an antimicrobial stewardship program. Vancomycin, commonly used to treat serious infections like MRSA, has been associated with increased nephrotoxicity risks, particularly when dosed above recommended therapeutic levels. The correlation factor equation was designed to quantify the association between supratherapeutic dosing and AKI incidence in hospitalized patients. Data from 386 patients over a 12-month period revealed an 8.8% incidence of AKI, though none were linked to supratherapeutic vancomycin dosing (AUC > 600 mg·h/L), resulting in a correlation factor of 0%. This finding underscores the importance of the correlation factor as a quantitative tool to assess dosing safety while emphasizing the need for its integration with ongoing pharmacy audits to optimize vancomycin use and enhance patient outcomes.