An Unusual Case of Low Vancomycin Exposure Despite Extremely High Vancomycin Doses Accompanied by Renal Toxicity: A Grand Round

Anne M. van Schip*, Jeske J. K. van Diemen, Reinier M. van Hest, Vanessa C. Harris

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Abstract:This grand round describes the case of a patient who received 10 grams (143.5 mg/kg) of vancomycin every 24 hours via continuous infusion, in whom the highest observed level was only 15.4 mg/L. Despite subtherapeutic levels, renal impairment was encountered, which resolved after the discontinuation of vancomycin. Glomerular hyperfiltration was found through nuclear glomerular filtration rate measurement, which likely explains the need for high doses (>6 grams per 24 hours continuous infusion) without reaching therapeutic serum levels.
Original languageEnglish
Pages (from-to)136-139
Number of pages4
JournalTherapeutic Drug Monitoring
Issue number2
Publication statusPublished - 1 Apr 2023

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