Vancomycin-Induced Nephrotoxicity in Adolescents Receiving Extended Infusion: Case Series. Issue 5 (September 2017)

• Record Type: Journal Article
• Authors: Bio, Laura L.; Nadeem, Komal
• Is Part Of: Infectious diseases in clinical practice. Volume 25:Issue 5(2017:Sep.)
• Publication Date: 2017-09
• Subjects: acute kidney injury -- glycopeptide -- supratherapeutic -- toxicity; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Periodicals; Electronic journals; 616.9
• DOI: 10.1097/IPC.0000000000000522
• Languages: English
• ISSNs: 1056-9103

Abstract

Abstract : Abstract: Because of concerns of red man syndrome, our institution increased standard vancomycin infusion duration to 90 minutes for 1000-mg doses and 120 minutes for 2000-mg doses. However, in children and adolescents, the dosing interval remained every 6 to 8 hours. The purpose of this pilot study was to identify the incidence of supratherapeutic vancomycin serum concentrations (VSCs) and nephrotoxicity with extended-infusion vancomycin (≥90 minutes). Of the 7 adolescents who received extended-infusion vancomycin, 1 (14.2%) experienced supratherapeutic VSC and nephrotoxicity. Extended-infusion vancomycin for red man syndrome should include assessment of the dosing interval and frequent VSC monitoring if a 6-hour interval is indicated. Abstract : This case series describes the incidence of nephrotoxicity in a small group of children that received prolongedinfusion vancomycin (> 60 minutes). Prolonged-infusion vancomycin may be implemented to preemptively reduce red man's syndrome or in response to the infusion-related reaction. The frequency dosing interval in children and prolonged infusion may result in accumulation and nephrotoxicity requiring close monitoring.