title: Eight unexpected cases of vancomycin associated acute kidney injury with contemporary dosing.
abstract: Vancomycin is one of the most commonly utilized antibiotics in US hospitals. It remains the drug of choice for the treatment of serious infections caused by methicillin-resistant Staphylococcus aureus. For many of these deep-seated infections, guidelines recommend achieving troughs of 15-20 mg/L for treatment efficacy. At our institution we observed a number of cases of presumed vancomycin-induced acute tubular necrosis clinically diagnosed by the nephrology service. We report eight cases of presumed vancomycin-induced acute tubular necrosis, three of which required hemodialysis before resolution of nephrotoxicity. Only three of the eight patients received nephrotoxins prior to development of nephrotoxicity. All eight patients ultimately recovered renal function following discontinuation.
authors.affiliation: Department of Pharmacy Practice, Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA; Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: O'Donnell
authors.affiliation: Division of Nephrology and Hypertension, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Cybele
authors.initials: C
authors.lastname: Ghossein
authors.affiliation: Department of Pharmacy Practice, Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA; Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Nathaniel J
authors.initials: NJ
authors.lastname: Rhodes
authors.affiliation: Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Tina
authors.initials: T
authors.lastname: Lertharakul
authors.affiliation: Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: C Kim
authors.initials: CK
authors.lastname: Pham
authors.affiliation: Department of Pharmacy Practice, Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA; Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA. Electronic address: mschee@midwestern.edu.
authors.forename: Marc H
authors.initials: MH
authors.lastname: Scheetz
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy; D014640:Vancomycin / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Acute tubular necrosis; Hemodialysis; Kidney injury; Vancomycin