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Published on: February 2, 2021
Concomitant Administration of Vancomycin with a High Dose of Meropenem May Cause Acute Kidney Injury
Yoshiro Sakai1,2, Seiji Karakawa1, Takato Koutaki1
1Department of Pharmacy, Kurume University Hospital, Kurume, Japan.
Abstract:
Coadministering two different classes of antibiotics as empirical therapy can be critical in treating healthcare-associated infections in hospitals. Herein, we report a case of acute kidney injury (AKI) caused by coadministration of vancomycin with high-dose meropenem that manifested as a rapid increase in serum creatinine levels and an associated increase in vancomycin trough concentrations. The patient was diagnosed with meningioma at 50 years and was followed up regularly. The patient underwent surgery and antibiotic treatment between 63 and 66 years for suspected meningitis and pneumonia. Coadministration of vancomycin with high-dose meropenem (6.0 g/day) caused AKI; however, no AKI occurred when vancomycin was administered alone or with a low dose of meropenem (1.5 or 3.0 g/day). To our knowledge, this report is the first to show that administering different dosages of meropenem in combination with vancomycin may contribute to the risk of developing AKI. We suggest that coadministered vancomycin and high-dose meropenem (6.0 g/day) may increase the risk of AKI. Our report adds to the limited literature documenting the coadministration of vancomycin with varying doses of meropenem and its impact on the risk of AKI and highlights the importance of investigating AKI risk in response to varying dosages of meropenem when it is coadministered with vancomycin.
Insights
High-dose meropenem combined with vancomycin may increase the risk of acute kidney injury (AKI). This case report highlights the importance of monitoring kidney function when using these antibiotic combinations, especially at higher meropenem dosages.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Empirical antibiotic coadministration is vital for hospital-acquired infections.
- Vancomycin and meropenem are commonly used antibiotics.
Observation:
- A patient developed acute kidney injury (AKI) with elevated creatinine and vancomycin levels.
- AKI occurred when vancomycin was given with high-dose meropenem (6.0 g/day).
- No AKI was observed with vancomycin alone or with lower meropenem doses (1.5 or 3.0 g/day).
Findings:
- High-dose meropenem (6.0 g/day) coadministered with vancomycin was associated with AKI.
- Lower doses of meropenem (1.5 or 3.0 g/day) did not cause AKI when given with vancomycin.
- This is the first report linking varying meropenem dosages with vancomycin to AKI risk.
Implications:
- Clinicians should consider meropenem dosage when coadministering with vancomycin.
- Monitoring for AKI is crucial in patients receiving vancomycin and high-dose meropenem.
- Further research is needed to elucidate the mechanism of meropenem-vancomycin-induced nephrotoxicity.
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