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International Journal of Clinical Pharmacy

, Volume 40, Issue 5, pp 1328–1334 | Cite as

Evaluation of risk factors for vancomycin-induced nephrotoxicity

  • So Jin Park
  • Na Ri Lim
  • Hyo Jung ParkEmail author
  • Jae Wook Yang
  • Min-Ji Kim
  • Kyunga Kim
  • Yong Won In
  • Young Mee Lee
Research Article
  • 266 Downloads

Abstract

Background Vancomycin is a glycopeptide antibiotic of choice for the treatment of serious infections caused by multi-resistant Gram-positive bacteria. However, vancomycin-associated nephrotoxicity (VAN) often limits its use. Previous data suggested a few risk factors of VAN, including higher mean vancomycin trough level, higher daily doses, old age, long duration of vancomycin therapy, and concomitant nephrotoxins. Objective To evaluate the incidence and risk factors of VAN and determine whether higher vancomycin trough concentrations were associated with a greater risk for VAN. Settings A retrospective, observational, single-center study at the 1960-bed university-affiliated tertiary care hospital (Samsung Medical Center), Seoul, Korea. Method A retrospective analysis of adult patients who received vancomycin parenterally in a tertiary care medical center from March 1, 2013 to June 30, 2013 was performed. We excluded patients with a baseline serum creatinine level > 2 mg/dL and those who had a history of end-stage renal disease and dialysis at baseline. The clinical characteristics were compared between patients with nephrotoxicity and those without nephrotoxicity to identify the risk factors associated with VAN. Main outcome measure Incidence of VAN and VAN-associated risk factors were analyzed. Results Of the 315 vancomycin-treated patients, nephrotoxicity occurred in 15.2% of the patients. In multivariate analysis, higher vancomycin trough concentrations of > 20 mg∕L (OR 9.57, 95% CI 2.49–36.83, p < 0.01) and intensive care unit (ICU) residence (OR 2.86, 95% CI 1.41–5.82, p < 0.01) were independently associated with VAN. Conclusion Our findings suggest that higher vancomycin trough levels and ICU residence might be associated with a greater risk for VAN. More careful monitoring of vancomycin serum trough levels and patient status might facilitate the timely prevention of VAN.

Keywords

Nephrotoxicity Risk factors Trough level Vancomycin 

Notes

Funding

This study has no specific funding sources.

Conflicts of interest

The authors declare that they have no conflicts of interest with regard to this paper.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • So Jin Park
    • 1
  • Na Ri Lim
    • 1
  • Hyo Jung Park
    • 1
    Email author
  • Jae Wook Yang
    • 1
    • 2
  • Min-Ji Kim
    • 1
    • 3
  • Kyunga Kim
    • 1
    • 3
  • Yong Won In
    • 1
  • Young Mee Lee
    • 1
  1. 1.Samsung Medical CenterGangnam-gu, SeoulRepublic of Korea
  2. 2.Department of Pharmaceutical SciencesSahmyook UniversitySeoulKorea
  3. 3.Statistics and Data center, Research Institute for Future MedicineSamsung Medical CenterSeoulKorea

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