A Downers Grove pharmacist-researcher has published findings that add to the case for changing how doctors monitor a common antibiotic in seriously ill children, potentially sparing young patients unnecessary kidney damage.

Dr. Marc H. Scheetz, associate dean of research and professor in the College of Pharmacy at Midwestern University's Downers Grove campus, led a research letter published Wednesday, July 22, in JAMA Network Open. The paper examined how clinicians monitor vancomycin, a powerful antibiotic given to children hospitalized with serious bacterial infections.

The core problem: getting the dose right is tricky. Too little vancomycin may fail to clear an infection. Too much can injure a child's kidneys.

Hospitals have long relied on "trough" monitoring, which measures the drug level in a patient's blood at a single point in time. But Scheetz's team, analyzing an international pediatric dataset, found that trough readings alone did not reliably show whether children were hitting recommended targets for total drug exposure over 24 hours.

The alternative is called area-under-the-curve (AUC) monitoring. It estimates a patient's full exposure across an entire day rather than a single snapshot.

"Our findings show that relying on trough concentrations alone may not accurately reflect a child's overall vancomycin exposure," Scheetz said in a statement accompanying the publication. "When clinicians use AUC-guided monitoring, they can make more informed dosing decisions that better balance effectiveness and safety for pediatric patients."

The practical consequence, according to the study: clinicians relying only on trough values may unnecessarily increase doses for children already receiving appropriate treatment, raising the risk of kidney injury without improving outcomes.

Justin Shiau, a Midwestern University infectious diseases pharmacotherapy fellow, served as the study's first author. Scheetz was the senior and corresponding author. He directs MWU's Pharmacometrics Center of Excellence and maintains a clinical affiliation with Northwestern Memorial Hospital in Chicago.

Scheetz said the pediatric results align with what researchers had previously observed in adults, extending the evidence base to younger patients and reinforcing clinical guidelines that already recommend AUC-guided monitoring when feasible.

The research letter is available open-access in JAMA Network Open (DOI: 10.1001/jamanetworkopen.2026.24892).