Wearable Device Delivers 5-Minute Data on Vancomycin Levels in Pilot Trial, With Sophie Stocker, MD

A pilot phase trial testing a wearable patch for continuous drug concentration measurement captured vancomycin levels in 5-minute intervals, demonstrating no safety or pain concerns in 6 participants.1

Study investigators suggest further development of this electrochemical aptamer-based patch device could aid precising vancomycin dosing, thereby potentially preventing antibiotic-induced acute kidney injury.1

“For a very long time, we've used trough concentrations to individualize therapy for drugs with a narrow therapeutic index, such as vancomycin, and it's quite a laborious process,” said study investigator Sophie Stocker, BsC, PhD, senior hospital scientist at St Vincent’s Hospital Sydney and a senior lecturer at The University of Sydney, in an interview with HCPLive. “We're always looking in the rear view mirror because we're collecting data from doses that have already been administered to the patient.”

Vancomycin is the predominant frontline antibiotic clinicians use to treat severe, drug-resistant infections, including those associated with hospital acquired infections associated with medical devices, caused by coagulase negative staphylococci. Additionally, it is the primary alternative for patients with a penicillin allergy.2,3

Despite its widespread use and efficacy, vancomycin can cause nephrotoxicity by accumulating with renal proximal tubule cells, leading to oxidative stress, mitochondrial dysfunction, and cellular apoptosis. This effect can be dose-dependent, with an increased risk at elevated concentrations > 20 mg/L or with prolonged therapy. Nephrotoxicity is a major cause of acute kidney injury, and can be linked to 60% of hospital-acquired causes.4,5,6

“Vancomycin associated kidney injury often happens because we're only checking levels maybe once a day at best, twice a day in the intensive care setting,” said Stocker. “So this continuous real time monitoring with the wearable patch essentially changes that completely, because you've got this information coming every 5 minutes, so clinicians can see very quickly when vancomycin exposure is starting to get too high, and they can start adjusting the dose very early on to prevent then acute kidney injury.”

To improve on the current blood sampling practices, study investigators conducted the pilot phase trials of wearable ‘patches’ bearing electrochemical aptamer-based sensors on small, solid needles.1

Overall, the patches were found to be safe and nearly pain-free, and they captured concentrations of vancomycin in the dermal interstitial fluid with 5-minute resolution over 24 hours. There was sensor degradation observed in participants, so the data primarily focuses on the first 12 hours.1

Using fitting interstitial fluid and plasma concentrations to compartmental pharmacokinetic models, investigators observed distribution and clearance dynamics not currently detected with sparse sampling approaches. Additionally, when patches were placed at different sites on the body, they exhibited consistent trends.1

Additional studies in clinical populations will be necessary to establish reliability over longer monitoring periods, validate correlations with plasma concentrations, and determine whether such data meaningfully improve dosing decisions or patient outcomes.

References

1. Stocker S, Erdal MK, Larson M, et al. Pilot phase clinical trial of a wearable, electrochemical aptamer-based patch for continuous drug concentration measurement. Nature Biotechnology. Published online February 4, 2026. doi:https://doi.org/10.1038/s41587-026-03010-w

2. Vazin A, Mahi Birjand M, Darake M. Evaluation of vancomycin therapy in the adult ICUs of a teaching hospital in southern Iran. Drug, Healthcare and Patient Safety. 2018;Volume 10:21-26. doi:https://doi.org/10.2147/dhps.s149451

3. Patel S, Preuss CV, Bernice F. Vancomycin. National Library of Medicine. Published October 29, 2024. https://www.ncbi.nlm.nih.gov/books/NBK459263/

4. Yasrebi-de Kom IAR, Jager KJ, Stel VS, et al. Vancomycin-Induced Acute Kidney Injury in Intensive Care Patients: A Target Trial Emulation Study Using Multicenter Routinely Collected Data. Pharmacoepidemiology and drug safety. 2025;34(9):e70205. doi:https://doi.org/10.1002/pds.70205

5. Vazin A, Mahi Birjand M, Darake M. Evaluation of vancomycin therapy in the adult ICUs of a teaching hospital in southern Iran. Drug, Healthcare and Patient Safety. 2018;Volume 10:21-26. doi:https://doi.org/10.2147/dhps.s149451

6. Kan WC, Chen YC, Wu VC, Shiao CC. Vancomycin-Associated Acute Kidney Injury: A Narrative Review from Pathophysiology to Clinical Application. International Journal of Molecular Sciences. 2022;23(4):2052. doi:https://doi.org/10.3390/ijms23042052