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.