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2016 ; 7
(3
): 136-47
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Review of vancomycin-induced renal toxicity: an update
#MMPMID27293542
Bamgbola O
Ther Adv Endocrinol Metab
2016[Jun]; 7
(3
): 136-47
PMID27293542
show ga
In recent times the use of larger doses of vancomycin aimed at curbing the
increasing incidence of resistant strains of Staphylococcus aureus has led to a
wider report of acute kidney injury (AKI). Apart from biological plausibility,
causality is implied by the predictive association of AKI with larger doses,
longer duration, and graded plasma concentrations of vancomycin. AKI is more
likely to occur with the concurrent use of nephrotoxic agents, and in critically
ill patients who are susceptible to poor renal perfusion. Although most
vancomycin-induced AKI cases are mild and therefore reversible, their occurrence
may be associated with greater incidence of end-stage kidney disease and higher
mortality rate. The strategy for its prevention includes adequate renal perfusion
and therapeutic drug monitoring in high-risk individuals. In the near future,
there is feasibility of renoprotective use of antioxidative substances in the
delivery of vancomycin.