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There was no difference in the percentage of patients experiencing clinical failure between the loading dose and no loading dose groups (74.8% 72.8%; = 0.698). Secondary outcomes were also similar between groups, including mortality and acute kidney injury, as was subgroup analysis based on site of infection. Exploratory analyses, including assessment of loading dose based on quartiles and a multivariable logistic regression model showed no differences. Use of vancomycin loading doses was not associated with improved clinical outcomes