Wearable Patch May Prevent Acute Kidney Injury

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

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

Realtime blood monitoring of antibiotic levels can potentially benefit pediatric patients and those in outpatient settings, pending the ability for clinicians to monitor patients from home.

“It would also be a big win in pediatrics, where blood sampling is complex and clinicians try to minimize it,” said study investigator Sophie Stocker, BsC, PhD, Associate Professor in the Sydney Pharmacy School, an Honorary Senior Hospital Scientist in the Department of Clinical Pharmacology and Toxicology at St Vincent's Hospital, Sydney, an Adjunct Senior Lecturer of the St Vincent's Clinical School, University of New South Wales, and an Honorary Scientist at the Garvan Medical Research Institute, in an interview with HCPLive. “Finally, in the outpatient setting, patients could go home with sensors applied while clinicians continue to receive continuous monitoring data—essentially providing hospital-level care at home. These are the key populations likely to benefit first.”

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 in 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

Stocker and investigators postured that having a continuous realtime monitoring wearable patch can provide immediate insight into vancomycin levels, thereby giving clinicians the option to adjust the dosage early to prevent acute kidney injury.

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

“This DNA aptamer sensing technology is very flexible and adaptable. The device developed by Nutromics is modular, so if you can create a DNA aptamer for any target—whether a drug molecule, a kidney function marker, or a toxicity marker—it can be monitored.”

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