How does vancomycin cause nephrotoxicity?
The exact mechanism of vancomycin-induced nephrotoxicity is not completely understood; however, current data suggest that use of the antibiotic causes oxidative effects on the proximal renal tubule resulting in renal tubular ischemia.
Does vancomycin cause Ain or ATN?
The mechanism behind VCM-induced AKI is still uncertain; however, animal models and a few biopsy-proven cases have shown that VCM could induce acute interstitial nephritis (AIN) and/or acute tubular necrosis (ATN) [4].
Does vancomycin cause acute tubular necrosis?
Results: A total of 89 patients received vancomycin over a 3-month period. Three patients developed ATN attributed to high levels of vancomycin, with an incidence of 3.4%. Conclusion: Intravenous vancomycin is nephrotoxic and can lead to ATN.
Is nephrotoxicity with vancomycin reversible?
Vancomycin-induced nephrotoxicity was reversible in the majority of cases, with short-term dialysis required only in 3% of nephrotoxic episodes. The collective literature indicates that an exposure-nephrotoxicity relationship for vancomycin exists.
What does vancomycin do to the kidneys?
Vancomycin is cleared primarily in the kidneys. In large amounts, vancomycin can cause kidney problems such as acute kidney injury (AKI). To calculate kidney function, clinicians collect a serum creatinine value. Creatinine is produced when muscles are broken down.
Does vancomycin cause ototoxicity?
Vancomycin has been in clinical use as a potent antistaphylococcal antibiotic for over 30 years. Most reports of ototoxicity and nephrotoxicity have been associated with early, relatively impure, formulations of vancomycin.
Does vancomycin cause acute kidney injury?
The risk of vancomycin-induced acute kidney injury increases with plasma vancomycin levels. Vancomycin-induced acute kidney injury is histologically characterized by acute interstitial nephritis and/or acute tubular necrosis.
How does vancomycin hurt the kidneys?
In animal studies, vancomycin has been associated with an increase in free radicals causing inflammation in the kidneys. In most patients, kidney damage caused by vancomycin is reversible and the kidneys recover on their own after the medication is stopped.
What are the adverse effects of vancomycin?
Side Effects
- Black, tarry stools.
- blood in the urine or stools.
- continuing ringing or buzzing or other unexplained noise in the ears.
- cough or hoarseness.
- dizziness or lightheadedness.
- feeling of fullness in the ears.
- fever with or without chills.
- general feeling of tiredness or weakness.
Is vancomycin safe in renal failure?
LAS VEGAS – Vancomycin is as safe on the kidneys of critically ill patients as linezolid, so long as trough levels don’t exceed the recommended upper limit of 20 mcg/mL, according to researchers from the University of Virginia in Charlottesville.
Is vancomycin harmful to kidneys?
Results of a small Johns Hopkins Children’s Center study show that hospitalized children given high-dose IV infusions of the antibiotic vancomycin to treat drug-resistant bacterial infections face an increased risk for kidney damage — an often reversible but sometimes serious complication.
Does vancomycin cause neutropenia?
Conclusions: Vancomycin-induced neutropenia is most likely associated with prolonged vancomycin exposure. Patients receiving vancomycin for longer than 7 days should have WBC count, differential, monitored weekly.
How does vancomycin cause nephrotoxicity in the kidney?
Literature on Vancomycin-induced Nephrotoxicity: Large Epidemiologic Surveys and Drug Toxicity & Efficacy Monitoring Studies (4) the failure to appreciate AKI causes accumulation of the renally excreted vancomycin, excess of which in turn inflicts further damage to the kidney, setting up a vicious cycle.
Why are there so many concerns about vancomycin?
Vancomycin has been plagued with concerns about nephrotoxicity since its approval in 1958. Initial preparations were termed “Mississippi mud” and had significant impurities considered the major reason for the nephrotoxicity. Through improved purification procedures, current preparations contain ∼90–95% vancomycin B (the active moiety).
Is the drug vancomycin responsible for MRSA nephrotoxicity?
Suggestions for clinical practice and future research are given. Vancomycin is the drug of choice for methicillin-resistant Staphylococcus aureus (MRSA) 1 but has been associated with significant nephrotoxicity. It remains uncertain, however, to what extent vancomycin is directly responsible.
What are the risk factors for AKI while taking vancomycin?
Numerous potential risk factors for development of AKI while receiving parenteral vancomycin therapy have been ascertained. Some factors are directly related to vancomycin exposure, such as total daily dose, duration of therapy, method of administration, trough level, and area under the concentration vs. time (AUC) curve.