TY - JOUR
T1 - An Unusual Case of Low Vancomycin Exposure Despite Extremely High Vancomycin Doses Accompanied by Renal Toxicity
T2 - A Grand Round
AU - van Schip, Anne M.
AU - van Diemen, Jeske J. K.
AU - van Hest, Reinier M.
AU - Harris, Vanessa C.
N1 - Publisher Copyright: © The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.
PY - 2023/4/1
Y1 - 2023/4/1
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
UR - http://www.scopus.com/inward/record.url?scp=85150372594&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150372594&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36728568
U2 - https://doi.org/10.1097/FTD.0000000000001061
DO - https://doi.org/10.1097/FTD.0000000000001061
M3 - Article
C2 - 36728568
SN - 0163-4356
VL - 45
SP - 136
EP - 139
JO - Therapeutic drug monitoring
JF - Therapeutic drug monitoring
IS - 2
ER -