The Nephrotoxicity of Vancomycin
نویسندگان
چکیده
Vancomycin use is often associated with nephrotoxicity. It remains uncertain, however, to what extent vancomycin is directly responsible, as numerous potential risk factors for acute kidney injury frequently coexist. Herein, we critically examine available data in adult patients pertinent to this question. We review the pharmacokinetics/pharmacodynamics of vancomycin metabolism. Efficacy and safety data are discussed. The pathophysiology of vancomycin nephrotoxicity is considered. Risk factors for nephrotoxicity are enumerated, including the potential synergistic nephrotoxicity of vancomycin and piperacillin-tazobactam. Suggestions for clinical practice and future research are given.
منابع مشابه
Elevated Vancomycin Trough Concentration: Increased Efficacy and/or Toxicity?
Vancomycin susceptibility of methicillin-resistant Staphylococcus aureus has been changed over time and its average minimum inhibitory concentration increased from 1.5 to 1.75 mg/L. A recently published guideline by the American Society of Health Pharmacist recommended a daily dose of 15-20 mg/kg every 8 to 12 hours of vancomycin to achieve a trough concentration between 15-20 mg/L for treatmen...
متن کاملElevated Vancomycin Trough Concentration: Increased Efficacy and/or Toxicity?
Vancomycin susceptibility of methicillin-resistant Staphylococcus aureus has been changed over time and its average minimum inhibitory concentration increased from 1.5 to 1.75 mg/L. A recently published guideline by the American Society of Health Pharmacist recommended a daily dose of 15-20 mg/kg every 8 to 12 hours of vancomycin to achieve a trough concentration between 15-20 mg/L for treatmen...
متن کاملIdentification of risk factors for nephrotoxicity in patients receiving extended-duration, high-trough vancomycin therapy.
BACKGROUND In the past, impurities in vancomycin formulations were thought to contribute to nephrotoxicity. In contrast, when current, purer formulations are dosed at conventional trough levels (i.e., 5-15 mg/L), the incidence of nephrotoxicity is relatively low. Recent guidelines have recommended targeting higher vancomycin trough levels in treatment of complicated methicillin-resistant Staphy...
متن کاملSystematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter.
In an effort to maximize outcomes, recent expert guidelines recommend more-intensive vancomycin dosing schedules to maintain vancomycin troughs between 15 and 20 mg/liter. The widespread use of these more-intensive regimens has been associated with an increase in vancomycin-induced nephrotoxicity reports. The purpose of this systematic literature review is to determine the nephrotoxicity potent...
متن کاملNephrotoxicity comparison of two commercially available generic vancomycin products.
To date, no comparative clinical studies have investigated the effects of different vancomycin products on nephrotoxicity. The objective of this single-center, retrospective, matched-cohort study was to investigate the impact of two different vancomycin products on the development of nephrotoxicity. The study population included adults receiving a single vancomycin product, from either Pfizer o...
متن کامل