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Related Experiment Videos

Multiple-dose activated charcoal in an accidental vancomycin overdose

S Kucukguclu1, Y Tuncok, H Ozkan

  • 1Dokuz Eylul University Hospital, Inciralti, Izmir, Turkey.

Journal of Toxicology. Clinical Toxicology
|January 1, 1996
PubMed
Summary

Multiple-dose activated charcoal (MDAC) effectively reduced vancomycin levels in a neonate experiencing an overdose. This method, known as gastrointestinal dialysis, shortened the drug's elimination half-life, offering a potential treatment strategy.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Toxicology

Background:

  • Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections.
  • Neonate vancomycin overdose can lead to severe toxicity, necessitating effective removal strategies.
  • Enterocapillary clearance of vancomycin may be enhanced by multiple-dose activated charcoal.

Observation:

  • A neonate with congenital anomalies received an accidental vancomycin overdose (500 mg IV).
  • The patient developed Red Man's Syndrome, characterized by hypotension, rash, and cyanosis.
  • Serum vancomycin levels were significantly elevated (165.7 µg/mL at 1 hour).

Findings:

  • Multiple-dose activated charcoal (1 g/kg every 4 hours for 12 doses) was administered 5 hours post-overdose.

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  • The elimination half-life of vancomycin during charcoal treatment was calculated to be ≤9.4 hours.
  • This is significantly shorter than the typical neonatal half-life of 13.4–33.7 hours.

    • Implications:

    • Gastrointestinal dialysis with MDAC appears to be a safe and effective method for enhancing vancomycin elimination in neonates.
    • This approach may prevent vancomycin-induced nephrotoxicity and other adverse effects in cases of overdose.
    • Further research is warranted to establish optimal MDAC protocols for vancomycin toxicity in neonates.