Protection Against Vancomycin-Associated Renal Injury

Melatonin may diminish vancomycin's nephrotoxicity by reducing oxidative stress in proximal tubular cells.

Vancomycin has long been a workhorse antibiotic against gram-positive infections, particularly methicillin-resistant Staphylococcus aureus (MRSA). While vancomycin-associated nephrotoxicity is uncommon, the surge in use and more-aggressive dosing strategies in the last 20 years (partially driven by community-acquired MRSA infections) have triggered a rise in acute kidney injury (AKI). Vancomycin-induced AKI may be mediated by oxidative stress on proximal tubular cells, which are highly metabolically active. As an antioxidant, can melatonin protect against such AKI?

Hong et al examined incidence of AKI (defined by an absolute increase in serum creatinine of >0.3 mg/dL or a >50% increase over baseline) in a retrospective single-center cohort s…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases