Adverse effects of vancomycin in children: a review of 22 cases

Reis, Amélia G.; Grisi, Sandra

doi:10.1590/s1516-31801997000300010

Cited by 3 publications

(3 citation statements)

References 15 publications

(2 reference statements)

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“…Nephrotoxicity was defined as increase in serum creatinine of 0.5 mg/dL or more or 50% of baseline for 2 consecutive days during the period from initiation of vancomycin therapy to 72 hours after completion of therapy. The specific adverse events we looked for were ototoxicity [17], hematologic [18][19][20][21], central nervous system [22,23], dermatologic [24][25][26][27] and cardiovascular [28,29].…”

Section: Inclusion Criteria and Outcomesmentioning

confidence: 99%

Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis

Steinmetz

Eliakim‐Raz

Goldberg

et al. 2015

Clinical Microbiology and Infection

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Recent Infectious Diseases Society of America guidelines for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections recommend maintaining vancomycin trough concentrations of 15-20 mg/L for serious infections. We conducted a systematic review and meta-analysis of all studies assessing the impact of low (<15 mg/L) vs. high (≥ 15 mg/L) vancomycin trough level on the efficacy of MRSA infections treatment. Four prospective and 12 retrospective studies were included (2003 participants). No significant difference was demonstrated between low and high vancomycin trough level for the outcome of all-cause mortality (odds ratio (OR) 1.07, 95% confidence interval (CI) 0.78-1.46, I(2) = 28%). In studies evaluating mainly MRSA pneumonia, there was significantly higher mortality with low vancomycin level (OR 1.78, 95% CI 1.11-2.84). No significant difference was demonstrated in treatment failure rates (OR 1.25, 95% CI 0.88-1.78, I(2) = 51%). However, excluding one outlier study from the analysis, treatment failure became significantly higher in patients with low vancomycin trough level (OR 1.46, 95% CI 1.12-1.91, I(2) = 16%). Microbiologic failure rates were significantly higher in patients with low vancomycin levels (OR 1.56, 95% CI 1.08-2.26, I(2) = 0%). Nephrotoxicity was significantly higher with vancomycin levels of ≥ 15 mg/L. However, no cases of irreversible renal damage were reported. Current data on the effectiveness of higher vancomycin trough levels in the treatment of MRSA infections are limited to few prospective and mainly retrospective studies. Our findings support the current recommendations for maintaining vancomycin trough levels of ≥ 15 mg/L in the treatment of severe MRSA infections, although no difference in all-cause mortality was observed.

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Section: Inclusion Criteria and Outcomesmentioning

confidence: 99%

Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis

Steinmetz

Eliakim‐Raz

Goldberg

et al. 2015

Clinical Microbiology and Infection

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“…To our knowledge, this is the first Indian study carried out to assess the steady-state pharmacokinetics of vancomycin in critically ill pediatric subjects. It is well known that short duration of vancomycin infusion is strongly associated with ADRs such as red man syndrome; 8,18,19 in the present study, all subjects received vancomycin infusion for the duration of 1 hour and it was well tolerated. However, one subject with hepatic dysfunction was discontinued from vancomycin and shifted to linezolid due to raised creatinine.…”

Section: Discussionmentioning

confidence: 69%

Steady-state Pharmacokinetics of Vancomycin in Children Admitted to Pediatric Intensive Care Unit of a Tertiary Referral Center

Mali

Tullu

Wandalkar

et al. 2019

Indian Journal of Critical Care Medicine

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Aims and objectivesVancomycin is a drug of choice for various gram-positive bacterial (GPB) infections and is largely prescribed to pediatric intensive care unit (PICU) patients. Despite the different pathophysiology of these patients, limited data are available on pharmacokinetics of vancomycin. There are lack of data for critically ill Indian children; hence, study was conducted to assess the steady-state pharmacokinetics in children admitted to PICU.Materials and methodsTwelve subjects (seven males, five females) aged 1–12 years were enrolled. Vancomycin (dose of 20 mg/kg per 8 hours) was infused for over 1 hour and steady-state pharmacokinetics was performed on day 3. Vancomycin concentrations were measured by the validated liquid chromatography mass spectrometry method. Pharmacokinetic parameters were calculated using Winnonlin (Version 6.3; Pharsight, St. Louis, MO).ResultsThe steady-state mean Cssmax was 40.94 μg/mL (±15.07), and mean AUC0–8 hours was 124.15 μg/mL (±51.27). The mean t1/2 was 4.82 hours (±2.71), Vd was 12.48 L (±4.43), and Cl was 2.08 mL/minute (±0.89). The mean AUC0–24 among 12 subjects was 372.44 μg/mL (±153.82). Among 35 measured trough concentrations, 23 (65.71%) were below, 11 (31.43%) were within, and 1 (2.86%) was above the recommended range.ConclusionThe pharmacokinetic parameters of vancomycin were comparable with previously reported studies. However, recommended trough levels (10–20 μg/mL) were not achievable with current recommended dosing of 60 mg/kg/day.How to cite this articleMali NB, Tullu MS, Wandalkar PP, Deshpande SP, Ingale VC, Deshmukh CT, et al. Steady-state Pharmacokinetics of Vancomycin in Children Admitted to Pediatric Intensive Care Unit of a Tertiary Referral Center. IJCCM 2019;23(11):497–502.

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“…Antimicrobials carry the risk of following cardiotoxicities: [55][56][57][58][59] (1) piperacillin-tazobactam has been shown to induce TdP; (2) fl uoroquinolones such as levofl oxacin may potentially prolong the QT interval and caution should be taken with co-administering them with class I and class III antiarrhythmic drugs and in electrolyte imbalances; (3) vancomycin has not been reported to induce any cardiac adverse events, except the vascular collapse; (4) azithromycin also has been implicated in QTc prolongation and proarrhythmic events, particularly with CQ/HCQ. It can interact with anticoagulants, antiarrhythmics, other QT prolonging agents, and statins.…”

Section: Antimicrobialsmentioning

confidence: 99%

A review of cardiovascular involvements associated with medications used to treat COVID-19 infection

Afshar¹,

Babazadeh²,

Janbakhsh³

et al. 2021

Cor Vasa

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Koronavirové onemocnění 2019 (COVID-19) se rychle rozšířilo po celém světě a vyvolalo globální krizi zdravotnických systémů. Toto onemocnění dnes představuje jednu z nejzávažnějších pandemií v historii lidstva; přitom postihuje řadu orgánů včetně celého kardiovaskulárního systému. U pacientů s onemocněním CO-VID-19 bylo popsáno poškození myokardu, myokarditida, akutní infarkt myokardu, dysrytmie a srdeční selhání. V současné době není k dispozici žádné specifi cké antivirotikum pro léčbu onemocnění COVID-19; zatím se používají některá léčiva jako interferon, remdesivir, ribavirin, favipiravir a tocilizumab. Tyto látky používané při léčbě onemocnění COVID-19 mohou mít nežádoucí účinky na kardiovaskulární systém, případně mohou interagovat s jinými farmaky určenými k léčbě kardiovaskulárních onemocnění. Nejzávažnějšími nežádoucími účinky těchto farmak jsou prodloužení intervalu QT a torsade de pointes (TdP), které mohou vést k náhlému úmrtí. V tomto článku popisujeme nežádoucí účinky různých farmak na kardiovaskulární systém i možné interakce mezi látkami používanými při léčbě onemocnění COVID-19 a farmaky uplatňujícími se v kardiologii.

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Adverse effects of vancomycin in children: a review of 22 cases

Cited by 3 publications

References 15 publications

Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis

Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis

Steady-state Pharmacokinetics of Vancomycin in Children Admitted to Pediatric Intensive Care Unit of a Tertiary Referral Center

A review of cardiovascular involvements associated with medications used to treat COVID-19 infection

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