Vancomycin for staphylococcal shunt site infections in patients on regular haemodialysis
British Medical Journal
|July 11, 1970
Abstract:
Six anuric patients with Scribner shunt site infections were treated by intermittent infusion of vancomycin into the shunt, and a satisfactory clinical response was obtained in five. Serum levels of the antibiotic were estimated frequently. From estimating serum levels and the minimum inhibitory concentrations of vancomycin for a range of hospital staphylococci a dose of 1g. vancomycin every seven days is recommended as a suitable schedule for treating staphylococcal infection in this situation.
Insights
Intermittent vancomycin infusion effectively treated Scribner shunt infections in five of six anuric patients. This antibiotic schedule is recommended for staphylococcal infections in similar clinical situations.
Area of Science:
- Infectious Diseases
- Nephrology
- Pharmacology
Background:
- Scribner shunt site infections are a complication in patients undergoing hemodialysis.
- Anuric patients often have compromised immune systems, increasing infection risk.
- Staphylococcal species are common pathogens in shunt infections.
Purpose of the Study:
- To evaluate the efficacy of intermittent vancomycin infusion for Scribner shunt site infections.
- To determine an optimal vancomycin dosing schedule based on serum levels and microbial susceptibility.
Main Methods:
- Six anuric patients with Scribner shunt infections received intermittent vancomycin infusions directly into the shunt.
- Serum vancomycin levels were monitored regularly.
- Minimum inhibitory concentrations (MICs) of vancomycin against relevant staphylococcal strains were determined.
Main Results:
- Five out of six patients achieved a satisfactory clinical response.
- Serum vancomycin levels correlated with clinical outcomes.
- A vancomycin dosage of 1g every seven days was found to be suitable.
Conclusions:
- Intermittent vancomycin infusion is a potentially effective treatment for Scribner shunt site infections.
- A regimen of 1g vancomycin every seven days is recommended for staphylococcal shunt infections in anuric patients.
More Related Videos
Related Concept Videos
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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...
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...
01:30Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
01:25Peritoneal Dialysis III: Nursing Management
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
01:25Hemodialysis I: Introduction
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
01:25Hemodialysis III: Nursing Management
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...