Effect of Vancomycin-Associated Acute Kidney Injury on Incidence of 30-Day Readmissions among Hospitalized Veterans Affairs Patients with Skin and Skin Structure Infections

Abstract

Among hospitalized adults who received vancomycin for their skin and skin structure infection (SSSI), patients who experienced acute kidney injury (AKI) had considerably higher 30-day readmission rates. Nearly half of the observed 30-day readmissions were due to non-SSSI-related reasons, consistent with the persistent organ dysfunction observed among patients with AKI.

The Safety and Efficacy of AUC/MIC-Guided vs Trough-Guided Vancomycin Monitoring Among Veterans

“…10 AKI occurred in 8.8% of patients and of those 19.4% were readmitted within 30 days. 10 Current literature lacks evidence regarding the comparison of the safety and efficacy of vancomycin trough-guided vs AUC/MIC-guided TDM in the veteran population. Therefore, the objective of this study was to investigate the differences in the safety and efficacy of vancomycin TDM in the veteran population based on the different monitoring methods used.…”

“…8 Previous studies evaluating the use of vancomycin in the veteran population have focused on AKI incidence, general nephrotoxicity, and 30-day readmission rates. 4,7,9,10 Poston-Blahnik and colleagues investigated the rates of AKI in 200 veterans using AUC/MIC-guided vancomycin TDM. 5 They found an AKI incidence of 42% of patients with AUC/MICs ≥ 550 mg × h/L and 2% of patients with AUC/MICs < 550 mg × h/L.…”

“…They found nephrotoxicity in 8.9% of patients. 10 Patel and colleagues investigated the effect of AKI on 30-day readmission rates in 216 veterans. 10 AKI occurred in 8.8% of patients and of those 19.4% were readmitted within 30 days.…”

“…10 Patel and colleagues investigated the effect of AKI on 30-day readmission rates in 216 veterans. 10 AKI occurred in 8.8% of patients and of those 19.4% were readmitted within 30 days. 10 Current literature lacks evidence regarding the comparison of the safety and efficacy of vancomycin trough-guided vs AUC/MIC-guided TDM in the veteran population.…”

Vancomycin Area Under the Curve‐guided Dosing and Monitoring: “Is the Juice Worth the Squeeze”?

“…Our group recently reported that adult hospitalized patients with skin and skin structure infections (SSSIs) who were treated with vancomycin and experienced VA‐AKI had considerably higher rates of 30‐day readmissions. Most 30‐day readmissions were non‐SSSI in nature and involved organ systems in AKI–remote organ crosstalk 33 …”