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Vancomycin nephrotoxicity

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https://www.readbyqxmd.com/read/29649586/nephrotoxicity-of-piperacillin-tazobactam-combined-with-vancomycin-should-it-be-a-concern
#1
Cafer Balcı, Ömrüm Uzun, Mustafa Arıcı, Sibel Aşçıoğlu Hayran, Deniz Yüce, Serhat Ünal
The combination of piperacillin-tazobactam (pip-tazo) and vancomycin provides a wide spectrum of activity against many pathogens acquired in the health-care setting. However, there have been reports of increased potential for nephrotoxicity with this combination. The aim of this study was to evaluate the nephrotoxic effect of pip-tazo plus vancomycin and compare it with that of pip-tazo and vancomycin alone, and meropenem plus vancomycin, another broad-spectrum combination. A total of 402 patients receiving either antimicrobial regimen for more than 48 hours were evaluated retrospectively in a two-year period...
April 9, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29642744/evaluation-of-continuous-infusion-vancomycin-administration-in-a-critically-ill-trauma-population
#2
Brittany D Bissell, Gina Riggi, Christopher Morrison
Vancomycin is a first-line antibiotic for empiric treatment of gram-positive infections in the trauma intensive care unit. When dosed intermittently, difficulties arise from trough collection and drug monitoring. The objective of this study was to evaluate time to goal vancomycin levels comparing a continuous infusion protocol when compared to standard intermittent infusion dosing. This was a retrospective cohort of patients admitted to the trauma intensive care unit between July 2011 and July 2015 receiving vancomycin for at least 48 hours...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29606259/-vancomycin-nephrotoxicity-frequency-and-mechanistic-aspects
#3
Yosu Luque, Laurent Mesnard
Vancomycin, discovered in 1953 and widely used today, has a nephrotoxic potential that has long been debated. The frequency of renal involvement is variable and can range from 5% to 30% depending concomitant risk factors: overdose, chronic kidney disease, obesity, hypovolemia, and use of other nephrotoxic drugs as aminoglycosides. Its association with piperacillin-tazobactam also appears to increase the risk of nephrotoxicity. This hypothesis should be confirmed experimentally. Vancomycin-induced oxidative stress in tubular cells and intraluminal cast formation are the two physiopathological mechanisms explaining its nephrotoxicity...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29590376/incidence-of-nephrotoxicity-among-pediatric-patients-receiving-vancomycin-with-either-piperacillin-tazobactam-or-cefepime-a-cohort-study
#4
Kathryn M Cook, Jessica Gillon, Alison G Grisso, Ritu Banerjee, Natalia Jimenez-Truque, Elizabeth J Phillips, Sara L Van Driest
Background: Recent studies in adults have found an incidence of acute kidney injury (AKI) in patients treated with a combination of vancomycin and piperacillin-tazobactam (TZP) that is greater than that expected with either medication alone. The purpose of this study was to determine whether combination therapy with vancomycin and TZP is associated with an incidence of AKI in pediatric patients higher than that in those on combination therapy with vancomycin and cefepime. Methods: We performed a retrospective single-center matched-cohort study of pediatric patients who received vancomycin in combination with TZP or cefepime between January 2015 and June 2016...
March 26, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29526331/nephrotoxicity-after-the-treatment-of-periprosthetic-joint-infection-with-antibiotic-loaded-cement-spacers
#5
Adam I Edelstein, Kamil T Okroj, Thea Rogers, Craig J Della Valle, Scott M Sporer
BACKGROUND: Treatment of periprosthetic joint infections commonly involves insertion of an antibiotic-loaded cement spacer (ACS). The risk for acute kidney injury (AKI) related to use of antibiotic spacers has not been well defined. We aimed to identify the incidence of and risk factors for AKI after placement of an ACS. METHODS: We performed a prospective cohort study of patients with an infected primary total hip or knee arthroplasty treated with ACSs with vancomycin, gentamicin, and tobramycin...
February 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29461449/optimizing-vancomycin-monitoring-in-pediatric-patients
#6
Abdullah Alsultan, Manal Abouelkheir, Saeed Alqahtani, Ahmad Aljabri, Ali M Somily, Sarah Alsubaie, Abdulkarim Alrabiaah, Elham Bukhari, Fahad Alzamil
INTRODUCTION: Several studies have reported that trough levels may not be optimal for monitoring vancomycin therapy, because of overexposure and nephrotoxicity risks. Therefore, we developed a population pharmacokinetic model to optimize vancomycin dosing and monitoring in pediatrics. METHODS: Data were retrospectively collected on 76 pediatric patients aged 1-12 years, admitted to general pediatric wards or ICUs at King Saud University Medical City, Riyadh, Saudi Arabia...
February 15, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29454592/effective-antimicrobial-stewardship-strategies-for-cost-effective-utilization-of-telavancin-for-the-treatment-of-patients-with-hospital-acquired-bacterial-pneumonia-caused-by-staphylococcus-aureus
#7
James A McKinnell, Shelby Corman, Dipen Patel, Grace H Leung, Lynne M Gordon, Thomas P Lodise
PURPOSE: Clinicians and stewardship programs are challenged with positioning of novel, higher priced antibiotic agents for the treatment of clinical infections. We developed a decision-analytic model to describe costs, including drug, total treatment costs, and health care outcomes, associated with telavancin (TLV) compared with vancomycin (VAN) for patients with Staphylococcus aureus (SA) hospital-acquired bacterial pneumonia (HABP). METHODS: This decision-analytic model assessed the treatment of SA-HABP with TLV versus VAN...
March 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29442542/comparison-of-the-nephrotoxicity-of-vancomycin-in-combination-with-cefepime-meropenem-or-piperacillin-tazobactam-a-prospective-multicenter-study
#8
Brandon P Mullins, C Joseph Kramer, Billie J Bartel, Jennifer S Catlin, Richard E Gilder
BACKGROUND: Patients often receive broad-spectrum antibiotics for nosocomial infections commonly with activity against Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Previous retrospective and/or single-center studies have suggested that the combination of vancomycin and piperacillin/tazobactam might be associated with an increased risk of acute kidney injury. OBJECTIVES: To compare the incidence of nephrotoxicity in patients receiving intravenous vancomycin in combination with cefepime, meropenem, or piperacillin/tazobactam...
February 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29348522/in-vitro-and-in-vivo-antimicrobial-activity-of-ts2037-a-novel-aminoglycoside-antibiotic
#9
Yoko Hirai, Kazunori Maebashi, Hideki Fushimi, Yukiko Hiraiwa, Shoichi Murakami, Takayuki Usui, Yoshihisa Akiyama, Nobuto Minowa, Daishiro Ikeda
To overcome serious methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa infections, we synthesized TS2037, 5,4″-diepi-arbekacin, a novel aminoglycoside antibiotic, and evaluated its biological properties. TS2037 showed broad-range, as well as robust antibacterial activities against Gram-positive and Gram-negative bacteria. The MIC50 and MIC90 of TS2037 against clinical isolates of MRSA (n = 54) were both 0.25 µg/mL, and no resistant strain was observed. The MIC50 and MIC90 of TS2037 against clinical isolates of P...
March 2018: Journal of Antibiotics
https://www.readbyqxmd.com/read/29280786/nephrotoxicity-with-vancomycin-in-the-pediatric-population-a-systematic-review-and-meta-analysis
#10
Theresa M Fiorito, Megan K Luther, Penelope H Dennehy, Kerry L LaPlante, Kelly L Matson
BACKGROUND: Vancomycin is frequently used to treat methicillin-resistant Staphylococcus aureus (MRSA) infections in pediatric patients. Vancomycin exposure may lead to an increase in frequency of nephrotoxicity. Our aim was to conduct a systematic review to describe predictors of nephrotoxicity associated with vancomycin, including documented trough concentrations ≥15mg/L. We also aimed to use a meta-analysis to assess the impact of a vancomycin trough ≥15 mg/L on nephrotoxicity...
December 26, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29260505/vancomycin-dosing-and-monitoring-critical-evaluation-of-the-current-practice
#11
Fawzy Elbarbry
After more than six decades of its use as the mainstay antibiotic for the treatment of multidrug-resistant Gram-positive bacterial infections, dosing and monitoring of vancomycin therapy have not been optimized. The current vancomycin therapeutic guidelines recommend empiric doses of 15-20 mg/kg administered by intermittent infusion every 8-12 h in patients with normal kidney function. Additionally, the guidelines recommend trough concentration of 15-20 mg/L as a therapeutic goal for adult patients with severe infections...
December 19, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29229640/adverse-effects-of-intravenous-vancomycin-based-prophylaxis-during-therapy-for-pediatric-acute-myeloid-leukemia
#12
Yilun Sun, Rachael L Huskey, Li Tang, Hiroto Inaba, Aditya H Gaur, Raul Ribeiro, Jeffrey E Rubnitz, Joshua Wolf
Children and adolescents with acute myeloid leukemia (AML) are at risk of life-threatening bacterial infections, especially with viridans group streptococci. Primary antibacterial prophylaxis with vancomycin-based regimens reduces this risk but might increase the risks of renal or liver toxicity or Clostridium difficile infection (CDI). A retrospective review of data for patients treated for newly diagnosed AML at St. Jude Children's Research Hospital between 2002 and 2008 was conducted. Nephrotoxicity was classified according to pediatric risk, injury, failure, loss, and end-stage renal disease (pRIFLE) criteria and hepatotoxicity according to Common Terminology Criteria for Adverse Events (CTCAE) criteria...
March 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29203493/prospective-trial-on-the-use-of-trough-concentration-versus-area-under-the-curve-to-determine-therapeutic-vancomycin-dosing
#13
Michael N Neely, Lauren Kato, Gilmer Youn, Lironn Kraler, David Bayard, Michael van Guilder, Alan Schumitzky, Walter Yamada, Brenda Jones, Emi Minejima
We hypothesized that dosing vancomycin to achieve trough concentrations of >15 mg/liter overdoses many adults compared to area under the concentration-time curve (AUC)-guided dosing. We conducted a 3-year, prospective study of vancomycin dosing, plasma concentrations, and outcomes. In year 1, nonstudy clinicians targeted trough concentrations of 10 to 20 mg/liter (infection dependent) and controlled dosing. In years 2 and 3, the study team controlled vancomycin dosing with BestDose Bayesian software to achieve a daily, steady-state AUC/MIC ratio of ≥400, with a maximum AUC value of 800 mg · h/liter, regardless of trough concentration...
February 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29193836/continuous-vancomycin-in-a-pediatric-cystic-fibrosis-patient
#14
Cameron J McKinzie, Charles R Esther, Timothy J Vece
Continuous vancomycin has been previously reported to maximize antimicrobial activity while avoiding toxicities associated with dose escalation, but the efficacy of this dosing strategy has not been reported. This case report describes the successful use of continuous vancomycin, including improvement in lung function and avoidance of nephrotoxicity, demonstrated in a pediatric cystic fibrosis (CF) patient with MRSA.
January 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29181890/pediatric-acute-kidney-injury-induced-by-concomitant-vancomycin-and-piperacillin-tazobactam
#15
Manal Abouelkheir, Sarah Alsubaie
BACKGROUND: Vancomycin is very commonly used in combination with piperacillin-tazobactam (PTZ) as the initial empiric treatment for moderate-severe infection, whenever coverage for both methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa is required. The combination of vancomycin and PTZ in adults has recently been reported to significantly increase the risk of acute kidney injury (AKI) relative to vancomycin monotherapy; such reports in pediatrics, however, are sparse...
February 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29109576/baseline-competency-assessment-of-pharmacists-prescribing-and-managing-vancomycin-therapy-in-the-regina-qu-appelle-health-region
#16
Kirsten Tangedal, Jennifer Bolt, Suzanne Len, Ali Bell
Background: Pharmacists in the Regina Qu'Appelle Health Region (RQHR), Saskatchewan, independently dose, monitor, and adjust vancomycin therapy. No framework exists for ongoing competency assessment of pharmacists. Objectives: The primary objective was to determine pharmacists' overall level of competency for all components of the vancomycin prescribing procedure. The secondary objectives were to determine competency for individual prescribing phases, to stratify overall competency in relation to pharmacist and patient factors, and to identify the 3 most frequent errors...
September 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29103776/systemic-absorption-of-antibiotics-from-antibiotic-loaded-cement-spacers-for-the-treatment-of-periprosthetic-joint-infection
#17
Adam I Edelstein, Kamil T Okroj, Thea Rogers, Craig J Della Valle, Scott M Sporer
BACKGROUND: Two-stage treatment of periprosthetic joint infections involves placement of high-dose antibiotic-loaded cement spacers (ACSs). Reports of ACS-induced nephrotoxicity have raised concern regarding systemic absorption of antibiotics after ACS placement. We sought to characterize the serum concentrations of antibiotics that occur after ACS placement. METHODS: We performed a prospective study of patients with an infected primary total hip (THA) or knee arthroplasty (TKA) treated with standardized ACSs with vancomycin, gentamicin, and tobramycin...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29095798/relationship-between-initial-vancomycin-trough-levels-and-early-onset-vancomycin-associated-nephrotoxicity-in-critically-ill-patients
#18
Masayuki Chuma, Makoto Makishima, Toru Imai, Naohiro Tochikura, Shinichiro Suzuki, Tsukasa Kuwana, Nami Sawada, Tomohide Komatsu, Takako Sakaue, Norikazu Kikuchi, Yoshikazu Yoshida, Kosaku Kinoshita
BACKGROUND: Appropriate initial dosing of vancomycin (VCM) is important in improving survival and in preventing nephrotoxicity in critically ill patients, but the potential relationship between initial VCM trough levels and early-onset nephrotoxicity remains unclear. We examined the relationship between initial VCM trough levels and early-onset VCM-associated nephrotoxicity. METHODS: We performed a retrospective study of patients who had therapeutic drug monitoring of VCM with initial trough levels within 4 days after the beginning of VCM administration...
February 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29080067/interventions-targeting-the-prescribing-and-monitoring-of-vancomycin-for-hospitalized-patients-a-systematic-review-protocol
#19
REVIEW
Cameron J Phillips, Alice J Wisdom, Ross A McKinnon, Richard J Woodman, David L Gordon
INTRODUCTION: Vancomycin remains one of our essential antibiotics after fifty years of treating serious infections such as methicillin-resistant Staphylococcus aureus. Vancomycin, unlike many other antibiotic agents, requires individualized dosing and monitoring of serum drug levels to ensure it is efficacious, to minimize toxicity, and to limit the development of antibiotic resistance. These issues have led to numerous vancomycin clinical practice guidelines being published in recent years including several key national guidelines...
December 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29063519/clinical-pharmacokinetics-and-pharmacodynamics-of-oxazolidinones
#20
REVIEW
Claire Roger, Jason A Roberts, Laurent Muller
Oxazolidinones are a class of synthetic antimicrobial agents with potent activity against a wide range of multidrug-resistant Gram-positive pathogens including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. Oxazolidinones exhibit their antibacterial effects by inhibiting protein synthesis acting on the ribosomal 50S subunit of the bacteria and thus preventing formation of a functional 70S initiation complex. Currently, two oxazolidinones have been approved by the US Food and Drug Administration: linezolid and more recently tedizolid...
October 23, 2017: Clinical Pharmacokinetics
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