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Nephrotoxicity with combination vancomycin-aminoglycoside therapy

Erin M Timpe1

  • 1Department of Pharmacy Practice, Southern Illinois University Edwardsville, Edwardsville, Illinois.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|November 3, 2012
PubMed
Abstract

Insights

Vancomycin and aminoglycoside combination therapy in pediatric patients does not appear to increase nephrotoxicity compared to individual drug use. This review of medical literature found no evidence of potentiated kidney damage in children.

Area of Science:

  • Pediatric Nephrology
  • Pharmacology
  • Clinical Toxicology

Background:

  • Vancomycin and aminoglycosides are commonly used antibiotics in pediatric care.
  • Both vancomycin and aminoglycosides are individually associated with nephrotoxicity.
  • The potential for increased nephrotoxicity when these agents are used in combination requires investigation.

Purpose of the Study:

  • To review existing medical literature on vancomycin-aminoglycoside induced nephrotoxicity in pediatric patients.
  • To determine if combined use of these antibiotics potentiates kidney damage in children.

Main Methods:

  • A comprehensive literature search was conducted using MEDLINE, EMBASE, and International Pharmaceutical Abstracts.
  • Included studies were case reports, letters, retrospective, and prospective evaluations of pediatric patients.
  • Data from 165 pediatric patients across six reports were compiled and analyzed.

Main Results:

  • Four of the six reviewed reports concluded that combination therapy does not potentiate nephrotoxicity.
  • Prospective studies consistently indicated no increased risk of kidney damage with combined vancomycin and aminoglycoside use.
  • Patient ages ranged from 3 days to 19 years.

Conclusions:

  • Current literature does not support the notion that combining vancomycin and aminoglycosides leads to greater nephrotoxicity than monotherapy.
  • Further research may be warranted, but existing evidence suggests a comparable safety profile regarding kidney function.
  • The findings are relevant for optimizing antibiotic regimens in pediatric populations.
Keywords:
adverse effectaminoglycosidedrug interactionnephrotoxicitypediatricvancomycin

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