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Vancomycin AND Nephrotoxicity

Shaoqi Qu, Cunchun Dai, Fengting Lang, Longfei Hu, Qihe Tang, Haixia Wang, Yanping Zhang, Zhihui Hao
Nephrotoxicity is the major limiting factor for the clinical use of vancomycin (VCM) for treatment of serious infections caused by multi-resistant Gram-positive bacteria. This study investigated the renal protective activity of rutin in a rat model of VCM-induced kidney injury in male Wistar rats. VCM intraperitoneally at 200 mg/kg twice daily for 7 successive days resulted in significant elevation of blood urea nitrogen and creatinine as well as urinary N-acetyl-β-D-glucosaminidase. Co-administration of VCM with oral rutin at 150 mg/kg significantly reduced these markers of kidney damage...
November 5, 2018: Antimicrobial Agents and Chemotherapy
N He, Y Y Yan, Y Q Ying, M Yi, G Q Yao, Q G Ge, S D Zhai
Pharmacokinetic parameters can be significantly altered for acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO) and continuous veno-venous hemofiltration therapy (CVVH). Here we reported a case of individualized vancomycin dosing for a patient diagnosed as severe acute pancreatitis treated with concurrent ECMO and CVVH. A 65 kg 32-year-old woman was admitted to hospital presented with severe acute pancreatitis (SAP), respiratory failure, metabotropic acidosis and hyperkalemia. She was admitted to intensive care unit (ICU) on hospital day 1 and was initiated on CVVH...
October 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Shungo Imai, Takehiro Yamada, Kumiko Kasashi, Yusuke Niinuma, Masaki Kobayashi, Ken Iseki
OBJECTIVES: In our previous study, we built a risk prediction model of vancomycin (VCM)-associated nephrotoxicity using decision tree (DT) analysis. However, this has several limitations in clinical applications. Our objective here was to construct a clinically applicable risk prediction model to be used at the time of initial therapeutic drug monitoring (TDM), in patients with uncomplicated infections. METHOD: A retrospective study was conducted at Hokkaido University Hospital...
October 2, 2018: Journal of Evaluation in Clinical Practice
Zuhal Uckun, Sevda Guzel, Necmiye Canacankatan, Cem Yalaza, Deniz Kibar, Banu Coskun Yilmaz
Vancomycin (VCM), a glycopeptide antibiotic, is a drug widely used in severe infections. However, VCM induce notable nephrotoxic side effects. Naringenin (NAR) is a natural of flavonoid and are known as strongly antioxidant, nefroprotective, antiapoptotic, and anti-inflammatory. The purpose of this study was to determine the potential protective effects of NAR against VCM-induced nephrotoxicity by measuring apoptotic and oxidative stress markers and evaluating histopathological alterations in rats. For this purpose, we used male Wistar albino rats that divided into seven groups: (i) Control [saline, intraperitoneally (i...
September 27, 2018: Drug and Chemical Toxicology
Talal Alzahrani, Angelike P Liappis, Larry M Baddour, Pamela E Karasik
BACKGROUND: Cefazolin is used as standard preoperative prophylaxis for a variety of surgical procedures that involve the skin. In contrast, vancomycin is recommended for a minority of patients, specifically those with an IgE-mediated allergy to beta-lactams and considered in patients with known colonization with methicillin-resistant Staphylococcus aureus or at high risk for such. Vancomycin, however, has been overprescribed, has nephrotoxicity risk, and may be less effective due to its inferior coverage of methicillin-susceptible S...
November 2018: Pacing and Clinical Electrophysiology: PACE
Atsushi Komoto, Takayoshi Maiguma, Daisuke Teshima, Tetsuhiro Sugiyama, Yuto Haruki
OBJECTIVE: We conducted a retrospective study based on composite endpoints for treatment failure to evaluate the effect of pharmacist-led VCM initial dose planning for Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia patients. METHODS: A retrospective cohort study was performed between pharmacist intervention and non-intervention groups. In this study, four types of failure were defined as the composite endpoint. When any one of the following failures occurred: 1) Death within 30 days from the start of VCM therapy, 2) Positive blood culture 7 days after the start of VCM therapy, 3) Change of VCM to another anti-MRSA agent, and 4) Development of nephrotoxicity, we considered that VCM treatment had failed...
2018: PloS One
Bryan T Mogle, Jeffrey M Steele, Robert W Seabury, Utkarsh J Dang, Wesley D Kufel
Limited evidence exists evaluating pharmacokinetic thresholds for vancomycin efficacy and nephrotoxicity using non-Bayesian methods. The objective of this study was to evaluate 24-hour steady-state vancomycin area under the concentration-time curve (AUC24 ) thresholds for efficacy and nephrotoxicity in patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (MRSA-B) after implementing two-point pharmacokinetic therapeutic drug monitoring (TDM). A single-center, retrospective cohort study was performed that included adult patients admitted between June 1, 2016 - January 1, 2018 with MRSA-B treated with vancomycin for ≥72 hours...
August 31, 2018: International Journal of Antimicrobial Agents
Diana J Schreier, Kianoush B Kashani, Ankit Sakhuja, Kristin C Mara, Mohammad S Tootooni, Heather A Personett, Sarah Nelson, Andrew D Rule, James M Steckelberg, Aaron J Tande, Erin F Barreto
Background: Nephrotoxins contribute to 20-40% of acute kidney injury (AKI) cases in the intensive care unit (ICU). The combination of piperacillin/tazobactam and vancomycin (PTZ/VAN) has been identified as nephrotoxic, but existing studies focus on extended durations of therapy rather than the brief empiric courses often used in the ICU. Objective: Compare the risk of AKI with a short course of PTZ/VAN to other anti-pseudomonal beta-lactam/vancomycin combinations...
August 24, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ling-Ling Zhu, Quan Zhou
Background: Sporadic studies in antimicrobial therapy have evaluated the effects of infusion rates on therapeutic and economic outcomes, and new findings may challenge the regular infusion regimen. Methods: Focusing on studies comparing the outcomes of different infusion regimens, the relevant literature was identified by searching PubMed, Web of Science, and Scopus from January 1, 2013 to March 1, 2018. Papers were finally chosen using a PRISMA flowchart. Results: Antimicrobials with the superiority of prolonged infusion to standard infusion in terms of efficacy and safety include meropenem, doripenem, imipenem, cefepime, ceftazidime, piperacillin/tazobactam, linezolid, and vancomycin...
2018: Infection and Drug Resistance
Min Huang, Hao Wu, Jing Zhou, Min Xu, Suming Zhou
BACKGROUND: Vancomycin is widely used for infections caused by gram-positive bacteria, but little attention has been paid to vancomycin in the treatment of critically ill patients aged ≥80 years. The aim of the current study was to investigate the efficacy of vancomycin and risk factors associated with nephrotoxicity of vancomycin in elderly critically ill patients. METHODS: A retrospective study was performed in a 14-bed medical-surgical geriatric ICU between January 2007 and June 2014...
August 1, 2018: Archives of Iranian Medicine
Jaime Barceló-Vidal, Eva Rodríguez-García, Santiago Grau
Vancomycin has usually been associated with nephrotoxicity. Generally, this toxicity is presented as proximal tubular cells injury with or without necrosis and as acute interstitial nephritis. However, development of both lesions is uncommonly described in literature. We present a case of vancomycin-induced nephrotoxicity resulting in both acute interstitial nephritis and tubular cells damage confirmed by renal biopsy. Peak and trough levels of 77.11 and 63.60 μg/mL, respectively, were obtained at the first plasma determination...
2018: Infection and Drug Resistance
Ketki Bhise, Samaresh Sau, Razieh Kebriaei, Seth A Rice, Kyle C Stamper, Hashem O Alsaab, Michael J Rybak, Arun K Iyer
Vancomycin is the treatment of choice for infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Clinically, combinations of vancomycin (VAN) and beta-lactams have been shown to improve patient outcomes compared to VAN alone for the treatment of MRSA bloodstream infections. However, VAN is known to cause nephrotoxicity, which could be ameliorated using biocompatible lipid drug delivery systems or liposomes. Previous attempts have been made for encapsulation of VAN in liposomes; however, drug loading has been poor, mainly because of the high aqueous solubility of VAN...
July 20, 2018: Materials
Fatih Mehmet Kandemir, Serkan Yildirim, Sefa Kucukler, Cuneyt Caglayan, Amdia Mahamadu, Muhammet Bahaeddin Dortbudak
Vancomycin (VCM) is a glycopeptidic broad-spectrum antibiotic against methicillin-resistant Staphylococcus aureus, though it has some adverse effects, including nephrotoxicity, that limit its usefulness. Zingerone (ZO), a component of dry ginger root, has several pharmacological activities due to its antioxidant, anti-inflammatory and antiapoptotic properties. The aim of this study was to determine the therapeutic efficacy of ZO against VCM-induced oxidative stress, inflammation, apoptosis and kidney aquaporin 1 (AQP1) levels in rats...
September 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Huifang Zhang, Ruilan Wang, Wen Shu, Rong Tang, Xiaoyu Liang, Jing Zhang, Jufang Wu
OBJECTIVE: To investigate the relationship between the serum level of vancomycin and its clinical efficacy as well as adverse reactions in adult patient so as to provide recommendations for clinical management. METHODS: An open observational research was performed from 1st July 2013 to 31st December 2017 in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, which recruited the adult patients who were infected with Gram positive (G+ ) bacteria and treated with vancomycin...
June 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
T Nakashima, K Koido, H Baba, R Otsuka, K Okinaka, T Sano, R Nishigaki, H Hashimoto, T Otsuka, M Esaki, H Terakado
BACKGROUND/AIM: Dose adjustment of vancomycin (VCM) is important in improving clinical outcomes and avoiding adverse effects such as nephrotoxicity. Although pharmacist-managed VCM therapy has been reported to optimize treatment, there are no studies focused on pharmacist expertise to date. In this study, we compared the contribution of pharmacists trained for infectious diseases and general pharmacists to dose adjustment of VCM. PATIENTS AND METHODS: We retrospectively investigated VCM trough concentration after dose adjustment by both trained (n = 67) and general (without special training for infectious diseases; n = 85) pharmacists...
July 1, 2018: Die Pharmazie
Amanda M Uber, Maria E Montez-Rath, David M Kwiatkowski, Catherine D Krawczeski, Scott M Sutherland
BACKGROUND: Though acute kidney injury (AKI) is often multifactorial, investigators are now emphasizing the specific contribution of nephrotoxins. This study examines the epidemiology of nephrotoxin exposure and nephrotoxin-associated AKI among children undergoing congenital heart surgery (CHS). METHODS: This is a retrospective cohort study of children admitted following CHS between June 1, 2014, and September 30, 2014. Nephrotoxins were defined according to the Nephrotoxic Injury Negated by Just-in-time-Action (NINJA) collaborative; high nephrotoxin exposure was defined as receipt of ≥ 3 nephrotoxins concurrently...
July 9, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Shijie Wen, Changyuan Wang, Xiaokui Huo, Qiang Meng, Zhihao Liu, Shilei Yang, Yanna Zhu, Huijun Sun, Xiaodong Ma, Kexin Liu
The present study aimed to investigate the regulation of JBP485 on the expressions of renal organic anion transporter (Oat) 1, Oat3, organic cation transporter 2 (Oct2), multidrug resistance-associated protein 2 (Mrp2) and P-glycoprotein (P-gp), which can accelerate the renal excretion of accumulated endogenous toxins to attenuate vancomycin-induced nephrotoxicity (VIN) in rats. Vancomycin suppressed the mRNA and protein expressions of Oat1, Oat3, Oct2, Mrp2 and P-gp to reduce the renal excretion of endogenous toxins (e...
October 1, 2018: Toxicology Letters
James Truong, Shawn R Smith, John J Veillette, Steven C Forland
Dosing vancomycin in critically ill patients often results in subtherapeutic and supratherapeutic trough concentrations. In this retrospective study, we compared the time to goal trough attainment and incidence of acute kidney injury in intensive care unit (ICU) patients whose vancomycin was dosed by a pharmacy pharmacokinetic (PK) dosing and monitoring service to the standard of care. Three-hundred fifty adult ICU patients at a Level 1 trauma, teaching hospital who received vancomycin for >24 hours from February 1, 2016, to November 30, 2016, were screened...
September 2018: Journal of Clinical Pharmacology
Jun Jie Benjamin Seng, Mei Hui Amanda Yong, Zi Xin Peh, Jie Lin Soong, Mooi Heong Tan
Background Vancomycin therapeutic drug monitoring (TDM) is commonly performed to ensure safe and effective use of the antibiotic. Aim of Study To evaluate appropriateness of vancomycin TDM and its outcomes in Singapore General Hospital. Method A retrospective, cross-sectional study was conducted between 1 January 2014 and 28 February 2014 involving patients who received ≥ 1 dose of intravenous vancomycin with TDM. Patient demographics and relevant vancomycin TDM data were collected from medical records...
October 2018: International Journal of Clinical Pharmacy
Erin F Barreto, Andrew D Rule, Stacy A Voils, Sandra L Kane-Gill
Over the last decade, the discovery of novel renal biomarkers and research on their use to improve medication effectiveness and safety has expanded considerably. Pharmacists are uniquely positioned to leverage this new technology for renal assessment to improve medication dosing and monitoring. Serum cystatin C is a relatively new, inexpensive, functional renal biomarker that responds more quickly to changing renal function than creatinine and is not meaningfully affected by age, sex, skeletal muscle mass, dietary intake, or deconditioning...
August 2018: Pharmacotherapy
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