Cohort study demonstrates that baseline blood counts and duration predict leukopenia risk during vancomycin therapy, indicating who needs closer laboratory monitoring.
Key Points
To develop and evaluate a risk-stratification strategy for laboratory-defined leukopenia and neutropenia based on baseline hematologic reserve and vancomycin treatment duration.
Conducted a cohort study monitoring laboratory-defined leukopenia and neutropenia during vancomycin therapy or within 3 days after discontinuation.
Constructed a 4-component baseline hematologic reserve score utilizing baseline white blood cell count, absolute neutrophil count, monocyte count, and hemoglobin.
Patients in the high-risk group treated for more than 14 days had the highest event rate of leukopenia/neutropenia at 75.0% (P < .001).
The baseline score model achieved an AUC of 0.697, which improved to an AUC of 0.786 in an extended model incorporating treatment duration and clinical covariates.