title: Influence of vancomycin infusion methods on endothelial cell toxicity.
abstract: Peripheral intravenous therapy is frequently used in routine hospital practice and, due to various factors, its most common side effect is phlebitis. The infusion of vancomycin is particularly associated with phlebitis despite its widespread use. French guidelines recommend central intravenous infusion for high concentrations of vancomycin, but peripheral intravenous therapy is often preferred in intensive care units. Methods of vancomycin infusion are either intermittent infusion or continuous infusion. A comparison of these methods under in vitro conditions simulating clinical use could result in better infusion efficacy. Human umbilical vein endothelial cells (HUVECs) were therefore challenged with clinical doses of vancomycin over a 24- to 72-h period using these infusion methods. Cell death was measured with the alamarBlue test. Concentration-dependent and time-dependent vancomycin toxicity on HUVECs was noted with a 50% lethal dose at 5 mg/ml after 24 h, reaching 2.5 mg/ml after 72 h of infusion, simulating long-term infusion. This toxicity does not seem to be induced by acidic pH. In comparing infusion methods, we observed that continuous infusion induced greater cell toxicity than intermittent infusion at doses higher than 1 g/day. The increasing use of vancomycin means that new guidelines are required to avoid phlebitis. If peripheral intravenous therapy is used to reduce infusion time, along with intermittent infusion, vein irritation and localized phlebitis may be reduced. Further studies have to be carried out to explore the causes of vancomycin endothelial toxicity.
authors.affiliation: University Lille Nord de France, Lille, France Department of Biopharmacy, Galenic and Hospital Pharmacy, UDSL, EA GRIIOT 4481, Lille 2 University, Lille, France Department of Pharmacy, Lille University Hospital, Lille, France.
authors.forename: Maryline
authors.initials: M
authors.lastname: Drouet
authors.affiliation: University Lille Nord de France, Lille, France INSERM U1008, Controlled Drug Delivery Systems and Biomaterials, Lille 2 University, Lille, France.
authors.forename: Feng
authors.initials: F
authors.lastname: Chai
authors.affiliation: University Lille Nord de France, Lille, France Department of Biopharmacy, Galenic and Hospital Pharmacy, UDSL, EA GRIIOT 4481, Lille 2 University, Lille, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Barthélémy
authors.affiliation: Department of Anesthesia and Intensive Care, Lille University Hospital, Lille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Lebuffe
authors.affiliation: Department of Anesthesia and Intensive Care, Poitiers University Hospital, INSERM U1070, Poitiers, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Debaene
authors.affiliation: University Lille Nord de France, Lille, France Department of Biopharmacy, Galenic and Hospital Pharmacy, UDSL, EA GRIIOT 4481, Lille 2 University, Lille, France Department of Pharmacy, Lille University Hospital, Lille, France bertrand.decaudin@univ-lille2.fr.
authors.forename: Bertrand
authors.identifier: http://orcid.org/0000-0001-8267-5594
authors.initials: B
authors.lastname: Décaudin
authors.affiliation: University Lille Nord de France, Lille, France Department of Biopharmacy, Galenic and Hospital Pharmacy, UDSL, EA GRIIOT 4481, Lille 2 University, Lille, France Department of Pharmacy, Lille University Hospital, Lille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Odou
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016923:Cell Death / Q000187:drug effects; D042783:Endothelial Cells / Q000187:drug effects*; D061307:Human Umbilical Vein Endothelial Cells; D006801:Humans; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin