Relationship Between Initial Vancomycin Trough Levels and Early-Onset Vancomycin-Associated Nephrotoxicity in Critically Ill Patients

Therapeutic Drug Monitoring
Masayuki ChumaKosaku Kinoshita

Abstract

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. 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. We excluded patients who received renal replacement therapy from 2 days before to 7 days after the beginning of VCM administration, were younger than 18 years, or had renal dysfunction before the beginning of VCM administration. Early-onset VCM-associated nephrotoxicity was defined as an increase in serum creatinine level of ≥0.5 mg/dL (44.2 μmol/L) or 50% above baseline for 2 or more consecutive days within 7 days after the beginning of VCM administration. Among 109 enrolled patients, 13 patients had early-onset VCM-associated nephrotoxicity. Its incidence rate was 31.3% in patients with initial trough levels of ≥20g/mL, which was significantly higher than 6.3% in patients with initial trough leve...Continue Reading

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Citations

Mar 15, 2019·European Journal of Clinical Pharmacology·Masayuki ChumaKosaku Kinoshita
May 18, 2020·The Journal of Antimicrobial Chemotherapy·Ioannis BellosVasilios Pergialiotis
Jan 15, 2021·Clinical Neuropharmacology·Meshal Saud AlotaibiNwair Saad Alshammari
Jun 10, 2021·Clinical Interventions in Aging·Yunchao WangChunyan Jiang

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