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Vancomycin‐Associated Renal Dysfunction: Where Are We Now?
Author(s) -
Carreno Joseph J.,
Kenney Rachel M.,
Lomaestro Ben
Publication year - 2014
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1488
Subject(s) - nephrotoxicity , vancomycin , medicine , intensive care medicine , adverse effect , trough level , renal replacement therapy , toxicity , staphylococcus aureus , tacrolimus , transplantation , biology , bacteria , genetics
Vancomycin has been in clinical use for over 60 years, during which time renal toxicity has been well documented. Multiple risk factors and outcomes are associated with vancomycin‐related nephrotoxicity. Risk factors include vancomycin exposure (trough levels 15 mg/L or higher, larger area under the curve, duration of therapy), host susceptibility to vancomycin (increased body weight, preexisting renal dysfunction, critical illness), and concurrent nephrotoxin therapy. Nephrotoxicity is associated with prolonged hospital stays, mortality, and the need for renal replacement therapy. To what degree vancomycin‐associated nephrotoxicity exacerbates these adverse clinical outcomes remains unclear. This article reviews the current evidence on vancomycin‐associated nephrotoxicity and explores future research directions with potential implications for improved patient safety.