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Frequency and factors associated with infusion-related local complications of vancomycin on peripheral venous

Helmi Ammar1,2, Simon Rolland3, Romain Jouffroy4,5,6,7

  • 1Centre Régional de Pharmacovigilance, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

The Journal of Antimicrobial Chemotherapy
|February 23, 2023
PubMed
Abstract

Insights

Vancomycin infusion is linked to local complications. Safe peripheral administration is possible with continuous infusion via volumetric pump at concentrations under 5 mg/mL, reducing infusion-related local complications.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Vancomycin is a key antibiotic for methicillin-resistant staphylococci.
  • Infusion-related local complications (IRLC) are a known risk with vancomycin administration.
  • Strategies to mitigate IRLC include increased dilution and continuous infusion via volumetric pumps.

Purpose of the Study:

  • To compare the incidence of IRLC between vancomycin and beta-lactam (BL) antibiotics.
  • To evaluate the safety of peripheral vancomycin infusion using a volumetric pump.
  • To identify factors associated with IRLC during vancomycin therapy.

Main Methods:

  • Prospective observational study conducted in a French tertiary hospital.
  • Inclusion of patients receiving continuous infusions of vancomycin or BL antibiotics via peripherally inserted venous catheters (PIVC).
  • Primary endpoint: occurrence of IRLC on Day 1 (D1).

Main Results:

  • 168 patients included (56 vancomycin, 112 BL).
  • Higher IRLC rates observed in the vancomycin group (25%) compared to the BL group (10%) at D1 (P=0.01).
  • Significantly more IRLC with vancomycin infused >5 mg/mL (53.3%) vs. BL (10%) (P<0.01); no difference observed at ≤5 mg/mL.

Conclusions:

  • Vancomycin can be safely administered peripherally via volumetric pump at concentrations ≤5 mg/mL.
  • This concentration threshold appears crucial for preventing infusion-related local complications.
  • Continuous infusion strategies may enhance vancomycin safety in peripheral settings.

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