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Vancomycin nephrotoxicity

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https://www.readbyqxmd.com/read/29461449/optimizing-vancomycin-monitoring-in-pediatric-patients
#1
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
#2
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...
February 14, 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
#3
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
#4
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...
January 18, 2018: Journal of Antibiotics
https://www.readbyqxmd.com/read/29280786/nephrotoxicity-with-vancomycin-in-the-pediatric-population-a-systematic-review-and-meta-analysis
#5
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. METHODS: A literature search was performed using PubMed, Cochrane Library, Embase, and Web of Sciences database...
December 26, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29260505/vancomycin-dosing-and-monitoring-critical-evaluation-of-the-current-practice
#6
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
#7
Yilun Sun, Rachael L Huskey, Li Tang, Hiroto Inaba, Aditya H Gaur, Raul Ribeiro, Jeffrey E Rubnitz, Joshua Wolf
Background Children and adolescents with acute myeloid leukemia (AML) are at risk of life-threatening bacterial infection, especially with viridans group streptococci. Primary antibacterial prophylaxis with vancomycin-based regimens reduces this risk, but might increase risk of renal or liver toxicity, or Clostridium difficile infection (CDI).Methods A retrospective review was conducted of patients treated for newly diagnosed AML at St. Jude Children's Research Hospital from 2002 to 2008. Nephrotoxicity was classified according to pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (RIFLE) criteria, and hepatotoxicity according to Common Terminology Criteria for Adverse Events criteria...
December 11, 2017: 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
#8
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
#9
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.
November 29, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29181890/acute-kidney-injury-induced-by-concomitant-use-of-vancomycin-and-piperacillin-tazobactam-in-pediatrics
#10
Manal Abouelkheir, Sarah Alsubaie
BACKGROUND: Vancomycin is very commonly used in combination with piperacillin-tazobactam (PTZ) as an initial empiric therapy for moderate to severe infections, whenever coverage for both methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa is required. The combination of vancomycin and PTZ in adults has recently been reported to significantly increase the risk of developing acute kidney injury (AKI) relative to vancomycin monotherapy; such reports in pediatrics are sparse...
November 27, 2017: 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
#11
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
#12
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
#13
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
#14
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...
October 27, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29063519/clinical-pharmacokinetics-and-pharmacodynamics-of-oxazolidinones
#15
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
https://www.readbyqxmd.com/read/29037461/sustained-improvement-in-vancomycin-dosing-and-monitoring-post-implementation-of-guidelines-results-of-a-three-year-follow-up-after-a-multifaceted-intervention-in-an-australian-teaching-hospital
#16
Cameron J Phillips, Ross A McKinnon, Richard J Woodman, David L Gordon
INTRODUCTION: Despite vancomycin being in use for over half-a-century, it is still not dosed or monitored appropriately in many centers around the world. The objective of this study was to determine the effectiveness of a multifaceted intervention to implement a vancomycin dosing and monitoring guideline across multiple medical and surgical units over time. METHODS: This was an observational before-and-after interventional cohort study. The pre-intervention period was August to December 2010-2011 and the post-intervention period was September to November 2012-2014...
October 13, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29035197/drug-induced-kidney-injury-a-large-case-series-from-the-berlin-case-control-surveillance-study%C3%A2
#17
Antonios Douros, Elisabeth Bronder, Andreas Klimpel, Christiane Erley, Edeltraut Garbe, Reinhold Kreutz
OBJECTIVES: Drug-induced kidney injury (DIKI) may affect patients regardless of their baseline kidney function. Therefore, this study evaluated DIKI in patients with or without previous chronic kidney disease (CKD). MATERIALS AND METHODS: Potential DIKI cases were ascertained using the network of the Berlin Case-Control Surveillance Study in all 51 Berlin hospitals from April 2010 until December 2011. Via face-to-face interviews and medical chart reviews, information on all previous drug intake, comorbidities, and demographics was gathered...
January 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29020249/increasing-evidence-of-the-nephrotoxicity-of-piperacillin-tazobactam-and-vancomycin-combination-therapy-what-is-the-clinician-to-do
#18
Richard R Watkins, Stan Deresinski
Early administration of appropriate empiric antibiotics is essential for achieving the best possible outcomes in sepsis. Yet the choice of antibiotic therapy has become more challenging due to recent reports of nephrotoxicity with the combination of vancomycin and piperacillin/tazobactam, the "workhorse" regimen at many institutions. In this article we assess the evidence for nephrotoxicity and its possible mechanisms, provide recommendations for risk mitigation, address the advantages and disadvantages of alternative antibiotic choices, and suggest areas for future research...
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28943633/vancomycin-induced-leukocytoclastic-vasculitis-and-acute-renal-failure-due-to-tubulointerstitial-nephritis
#19
Chandra Shekar Pingili, Emmanuel E Okon
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and sepsis are commonly treated with intravenous vancomycin. However, vancomycin treatment is associated adverse reactions, including skin rashes and nephrotoxicity. We present a case of acute renal failure due to acute tubulointerstitial nephritis associated with a diffuse leukocytoclastic vasculitic skin eruption following intravenous vancomycin treatment. CASE REPORT A 79-year-old Caucasian male patient was treated with intravenous vancomycin for MRSA bacteremia...
September 25, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28923869/a-quasi-experiment-to-study-the-impact-of-vancomycin-area-under-the-concentration-time-curve-guided-dosing-on-vancomycin-associated-nephrotoxicity
#20
Natalie A Finch, Evan J Zasowski, Kyle P Murray, Ryan P Mynatt, Jing J Zhao, Raymond Yost, Jason M Pogue, Michael J Rybak
Evidence suggests that maintenance of vancomycin trough concentrations at between 15 and 20 mg/liter, as currently recommended, is frequently unnecessary to achieve the daily area under the concentration-time curve (AUC 24 ) target of ≥400 mg · h/liter. Many patients with trough concentrations in this range have AUC 24 values in excess of the therapeutic threshold and within the exposure range associated with nephrotoxicity. On the basis of this, the Detroit Medical Center switched from trough concentration-guided dosing to AUC-guided dosing to minimize potentially unnecessary vancomycin exposure...
December 2017: Antimicrobial Agents and Chemotherapy
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