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The Nephrotoxicity of Vancomycin

E J Filippone1,2, W K Kraft3, J L Farber4

  • 1Department of Medicine, Sydney Kimmel College of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Clinical Pharmacology and Therapeutics
|May 6, 2017
PubMed

Insights

Vancomycin can harm kidneys, but its direct role in acute kidney injury is unclear due to other risk factors. This review examines vancomycin

Area of Science:

  • Pharmacology and Nephrology
  • Clinical Pharmacy and Therapeutics

Background:

  • Vancomycin is frequently linked to nephrotoxicity.
  • The precise contribution of vancomycin to acute kidney injury (AKI) is debated due to coexisting risk factors.

Purpose of the Study:

  • To critically evaluate the available data on vancomycin-induced nephrotoxicity in adult patients.
  • To review vancomycin pharmacokinetics, pharmacodynamics, efficacy, safety, and the pathophysiology of kidney injury.

Main Methods:

  • Literature review of adult patient data.
  • Analysis of pharmacokinetic/pharmacodynamic properties.
  • Examination of efficacy, safety, and risk factor data.

Main Results:

  • The direct nephrotoxic role of vancomycin remains uncertain.
  • Coexisting risk factors and potential synergistic effects (e.g., with piperacillin-tazobactam) complicate assessment.
  • Specific risk factors for vancomycin-associated nephrotoxicity are identified.

Conclusions:

  • Further research is needed to clarify vancomycin's direct nephrotoxic potential.
  • Clinical practice should consider identified risk factors and potential drug interactions.
  • Strategies to mitigate vancomycin-related kidney injury require further investigation.

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