6.
Conclusion
In conclusion, vancomycin TDM is essential in order to achieve optimum
clinical response with minimal unwanted adverse reactions associated
with vancomycin over-dose exposure. Different pharmacokinetic parameters
have been considered for the purposes of vancomycin TDM establishment.
The most common approaches are AUC-guided TDM and trough
concentration-guided TDM. According to the results of many studies noted
in the present review, it seems that AUC-guided TDM could be associated
with lower risk of vancomycin associated AKI. Also, due to the altered
pharmacokinetic parameters in patients with special conditions including
renal failure, hepatic failure, cancer, organ transplantation, obesity,
pregnancy, lactation, burn injuries, critically ill patients, etc.
individualized dosing regimen is required to guarantee the optimum
therapeutic results and minimize severe adverse reactions such as AKI.