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

doi:10.1097/FTD.0000000000001061

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

Internal medicine

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 language	English
Pages (from-to)	136-139
Number of pages	4
Journal	Therapeutic Drug Monitoring
Volume	45
Issue number	2
DOIs	https://doi.org/10.1097/FTD.0000000000001061
Publication status	Published - 1 Apr 2023

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

abstract = "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.",

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note = "Publisher Copyright: {\textcopyright} The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.",

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AU - van Hest, Reinier M.

AU - Harris, Vanessa C.

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N2 - 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.

AB - 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.

KW - ADME approach

KW - hyperfiltration

KW - pharmacology

KW - vancomycin

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UR - https://www.ncbi.nlm.nih.gov/pubmed/36728568

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

Abstract

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