Related Experiment Video
Updated: Jun 10, 2025
Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
Published on: May 6, 2018
Combined nephrotoxicity of Polymyxins and Vancomycin: a study on adverse event reporting for monotherapy versus
Ruijia Zhan1, Jiageng Lin1, Miao Dai1
1Department of Clinical Medicine, Southern Medical University, Guangzhou, China.
Background:
Multidrug-resistant (MDR) infections pose a global public health crisis with significant mortality and economic burdens. Combination of polymyxins and vancomycin has shown effectiveness against MDR infections. However, their combined nephrotoxicity complicates clinical use. Given these concerns, we conducted a pharmacovigilance analysis using the FDA Adverse Event Reporting System (FAERS) to assess the nephrotoxicity of combinations of polymyxins and vancomycin compared to monotherapy.
Research Design And Methods:
In this retrospective study, data from FAERS reports (2012 Q4 to 2023 Q2) were deduplicated and analyzed for adverse events (AEs) related to vancomycin, polymyxin B, and colistin. Disproportionality analyses were performed to evaluate the association between drugs and nephrotoxicity.
Results:
A total of 9,796,784 adverse event reports, including 73,009 reports associated with nephrotoxicity, were included. All three drugs showed significant associations with nephrotoxicity. In combination therapy, polymyxin B-vancomycin exhibited a stronger association with nephrotoxicity compared to monotherapy, whereas colistin-vancomycin demonstrated a lower association with nephrotoxicity than colistin monotherapy.
Conclusions:
This study found that combining vancomycin with colistin alleviated colistin-induced nephrotoxicity, while combining vancomycin with polymyxin B worsened polymyxin B-induced nephrotoxicity.
Insights
Combining vancomycin with colistin reduced kidney damage, but adding vancomycin to polymyxin B increased nephrotoxicity in multidrug-resistant infections.
Area of Science:
- Pharmacovigilance
- Nephrology
- Infectious Diseases
Background:
- Multidrug-resistant (MDR) infections present a global health challenge.
- Combination therapy with polymyxins and vancomycin is effective but raises concerns about nephrotoxicity.
- Pharmacovigilance is crucial for assessing drug safety profiles.
Purpose of the Study:
- To evaluate the nephrotoxicity of vancomycin-polymyxin combinations versus monotherapy.
- To compare the safety profiles of vancomycin-colistin and vancomycin-polymyxin B combinations.
- To analyze real-world adverse event data for drug-induced kidney injury.
Main Methods:
- Retrospective analysis of FDA Adverse Event Reporting System (FAERS) data from Q4 2012 to Q2 2023.
- Deduplication and analysis of adverse event reports for vancomycin, polymyxin B, and colistin.
- Disproportionality analyses to assess the association between drug combinations and nephrotoxicity.
Main Results:
- All analyzed drugs (vancomycin, polymyxin B, colistin) were associated with nephrotoxicity.
- Vancomycin-polymyxin B combination showed a stronger association with nephrotoxicity than monotherapy.
- Vancomycin-colistin combination demonstrated a lower association with nephrotoxicity than colistin monotherapy.
Conclusions:
- Combining vancomycin with colistin may mitigate colistin-induced nephrotoxicity.
- Combining vancomycin with polymyxin B appears to exacerbate polymyxin B-induced nephrotoxicity.
- These findings have implications for optimizing combination antibiotic therapy in MDR infections.
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:19Pharmacovigilance
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:20Acute Kidney Injury V: Interprofessional Care
01:15Drug Elimination by Renal Route: Tubular Secretion
01:10Nephrons