When Is Vancomycin Nephrotoxic in Critically Ill Patients?

Parameters significantly associated with nephrotoxicity were higher median vancomycin serum trough levels, concomitant vasopressor use, longer duration of therapy, and intermittent infusion.

Vancomycin is standard treatment for multidrug-resistant gram-positive pathogens, including methicillin-resistant Staphylococcus aureus. However, despite dosing adjusted according to renal function and vancomycin trough levels, nephrotoxicity remains a concern. The likelihood of such nephrotoxicity may increase now that current guidelines recommend higher trough serum concentrations (15–20 mg/L, rather than 5–10 mg/L) for treatment of severe infections.

To determine factors associated with vancomycin nephrotoxicity, researchers conducted a retrospective cohort study involving critically ill patients who received vancomycin therapy at one U.K. hospital between December 2004 and August 2009 (N=1430).

Multivariate analysis identified longer dura…

Reviewing Author

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

When Is Vancomycin Nephrotoxic in Critically Ill Patients?

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Reviewing Author