Premium
The Nephrotoxicity of Vancomycin
Author(s) -
Filippone EJ,
Kraft WK,
Farber JL
Publication year - 2017
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.726
Subject(s) - nephrotoxicity , vancomycin , medicine , piperacillin/tazobactam , intensive care medicine , acute kidney injury , piperacillin , pharmacokinetics , pharmacology , kidney , biology , staphylococcus aureus , bacteria , pseudomonas aeruginosa , genetics
Vancomycin use is often associated with nephrotoxicity. It remains uncertain, however, to what extent vancomycin is directly responsible, as numerous potential risk factors for acute kidney injury frequently coexist. Herein, we critically examine available data in adult patients pertinent to this question. We review the pharmacokinetics/pharmacodynamics of vancomycin metabolism. Efficacy and safety data are discussed. The pathophysiology of vancomycin nephrotoxicity is considered. Risk factors for nephrotoxicity are enumerated, including the potential synergistic nephrotoxicity of vancomycin and piperacillin‐tazobactam. Suggestions for clinical practice and future research are given.