Does AUC/MIC Ratio Predict Efficacy and Safety of Vancomycin?

In this review, the studies in which potential correlation between the area under the curve/minimum inhibitory concentration ratio of vancomycin (AUC/MIC) and its efficacy and safety had been considered, were assessed. Papers that had defined the potential correlation between vancomycin AUC/MIC and its efficacy, safety, or both as a primary outcome were included. Considering that extent of vancomycin exposure as well as susceptibility of microorganisms were both included, AUC/MIC seemed to be a more accurate index than serum trough concentration for predicting vancomycin efficacy. However, data regarding correlation between this index and vancomycin-induced nephrotoxicity are limited. Different breakpoints have been defined for AUC/MIC. The optimized use of vancomycin can improve its efficacy and defer the occurrence of tolerance. Further studies are needed to define optimum vancomycin AUC/MIC breakpoints and in turn predict its efficacy and safety.