title: Absorption of oral vancomycin - possible associated toxicity.
abstract: We report a case of an anephric child who accumulated significant concentrations of vancomycin during oral therapy for Clostridium difficile pseudomembranous colitis. Sustained serum vancomycin levels of 34 microgram/ml and CSF level of 4.2 microgram/ml were documented during an unexplained clinical syndrome of fever and encephalopathy. Discontinuation of drug and performance of hemodialysis reduced serum concentrations to 24 microgram/ml and were associated with rapid resolution of symptoms. Patients with renal impairment and intestinal disease who receive oral vancomycin may absorb and accumulate significant amounts of drug.
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D001927:Brain Diseases / Q000139:chemically induced*; D003015:Clostridium Infections / Q000188:drug therapy; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D014640:Vancomycin / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D014640:Vancomycin