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Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
Published on: January 7, 2015
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Influence of vancomycin infusion methods on endothelial cell toxicity
Maryline Drouet1, Feng Chai2, Christine Barthélémy3
1University 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.
Antimicrobial Agents and Chemotherapy
|November 26, 2014
Summary
Vancomycin infusion can cause phlebitis. Continuous infusion of vancomycin, especially peripherally, shows greater endothelial cell toxicity than intermittent infusion, suggesting a need for revised guidelines.
Area of Science:
- Vascular biology
- Pharmacology
- Cellular toxicology
Background:
- Peripheral intravenous therapy is common but often causes phlebitis.
- Vancomycin infusion is frequently linked to phlebitis, despite its necessity.
- Current guidelines suggest central infusion for high vancomycin concentrations, yet peripheral infusion persists in ICUs.
Purpose of the Study:
- To compare the in vitro endothelial toxicity of vancomycin via intermittent versus continuous peripheral infusion.
- To evaluate vancomycin's concentration- and time-dependent toxicity on human umbilical vein endothelial cells (HUVECs).
Main Methods:
- HUVECs were exposed to clinical doses of vancomycin for 24–72 hours.
- Two infusion methods (intermittent and continuous) were simulated.
- Cell death was quantified using the alamarBlue assay.
Main Results:
- Vancomycin exhibited concentration- and time-dependent toxicity on HUVECs.
- The 50% lethal dose decreased from 5 mg/ml at 24 hours to 2.5 mg/ml at 72 hours.
- Continuous infusion showed greater HUVEC toxicity than intermittent infusion at doses exceeding 1 g/day.
Conclusions:
- Vancomycin induces endothelial toxicity, particularly with continuous peripheral infusion.
- Intermittent peripheral vancomycin infusion may reduce vein irritation and phlebitis.
- Further research is needed to understand the mechanisms of vancomycin-induced endothelial toxicity and inform new guidelines.
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