Impact of Recent Methamphetamine Use on Vancomycin Clearance

S Andrea Laguado1, Nina Vadiei1, Kateryna Yenina1

  • 1S. Andrea Laguado, Pharm.D, Nina Vadiei, Pharm.D, BCPP, Kateryna Yenina, Pharm.D, BCPS, The University of Arizona/Banner University Medical Center South, Tucson, Arizona.

Abstract

Insights

Recent methamphetamine use appears to increase vancomycin clearance. However, this stimulant drug did not significantly affect achieving target vancomycin trough levels in patients. Further research is needed.

Area of Science:

  • Pharmacokinetics
  • Clinical Pharmacology
  • Toxicology

Background:

  • Vancomycin is a critical antibiotic for treating serious Gram-positive infections.
  • Understanding factors influencing vancomycin clearance is crucial for optimizing therapeutic efficacy.
  • The impact of recreational drug use, such as methamphetamine, on drug metabolism is not well-established.

Purpose of the Study:

  • To investigate the association between recent methamphetamine use and vancomycin clearance.
  • To determine if methamphetamine use influences the achievement of target vancomycin trough concentrations.

Main Methods:

  • Retrospective, multi-center study involving adult patients receiving vancomycin.
  • Patients were categorized based on urine drug screen results for amphetamines.
  • Vancomycin clearance and trough concentrations were primary outcome measures.

Main Results:

  • Vancomycin clearance was significantly higher in patients with recent methamphetamine use (94.54 mL/min) compared to controls (86.84 mL/min).
  • No significant difference in achieving goal vancomycin trough levels was observed between the groups.
  • Increased vancomycin clearance was also associated with higher BMI and cocaine use.

Conclusions:

  • Recent methamphetamine use may be associated with increased vancomycin clearance.
  • Further prospective studies are warranted to confirm these findings and explore the impact on therapeutic drug monitoring.

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