High-Dose Vancomycin and Nephrotoxicity

The incidence of nephrotoxicity was higher with vancomycin doses ≥4 g/day than with lower vancomycin doses or with linezolid.

High doses of vancomycin may be needed to achieve trough levels of 15–20 µg/mL, which are recommended for healthcare-associated pneumonia and meningitis. In a retrospective cohort study funded by the maker of linezolid, investigators compared the incidence of nephrotoxicity among patients taking high-dose (≥4 g/day) vancomycin, standard-dose (<4 g/day) vancomycin, or linezolid. Groups were well matched, except for significant differences in the male:female ratio and in the proportions of patients who had respiratory tract or central nervous system infections, were in the ICU at treatment initiation, and received concomitant aminoglycoside therapy (all highest in the high-dose vancomycin group).

Nephrotoxicity — defined as a serum creatinine …

Reviewing Author

Lynn L. Estes, PharmD

Disclosures

Editorial boardsMayo Clinic Antimicrobial Therapy Quick Guide

Lynn L. Estes, PharmD

Disclosures

Editorial boardsMayo Clinic Antimicrobial Therapy Quick Guide