title: Successful utilization of high-flux hemodialysis for treatment of vancomycin toxicity in a child.
abstract: Vancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity. We report a case of a pediatric patient who developed vancomycin toxicity and associated oliguric renal failure who was treated effectively with high-flux hemodialysis for vancomycin toxicity, clearing serum concentrations of vancomycin by over 75% in only 6 hours (213.2 mcg/mL to 51.8 mcg/mL) with subsequent return to baseline renal function and without adverse sequelae. While not historically considered a viable option for drug removal in cases of toxicity, new high-flux hemodialysis techniques can remove significant percentages of vancomycin in short periods of time.
authors.affiliation: Pediatric Intensive Care Unit, Section of Critical Care Medicine, Children's Hospital Colorado and University of Colorado at Denver, 13123 East 17th Avenue, Mail Stop 8414, Aurora, CO 80045, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Stidham
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Reiter
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Ford
authors.forename: Gary M
authors.initials: GM
authors.lastname: Lum
authors.forename: Joseph
authors.initials: J
authors.lastname: Albietz