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A subsequent cohort study in 2020 by Gaggl et al found no increased nephrotoxicity with vancomycin with an adjusted hazard ratio for vancomycin versus all other comparators of 0.74 (95% CI 0.45-1.21), although the authors admit residual confounding might remain

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In addition, the analgesic effect of melatonin is mediated through activation of supraspinal sites, inhibition of spinal nociception, and modulation of various neurobiological systems, including GABAergic, opioid, and glutamatergic systems [65]