Reactions 1680, p164 - 2 Dec 2017 Acute kidney injury: case report In a retrospective study of 243 patients, a patient [age and sex not stated] was described, who developed acute kidney injury during treatment with vancomycin, tobramycin and ibuprofen [not all indications and routes stated]. The patient, who had a history of cystic fibrosis and methicillin-resistant Staphylococcus aureus infection, started receiving treatment with IV vancomycin 20 mg/kg per dose every 12 hours. Subsequently, the patient showed an increase in serum creatinine from 0.71 to 2.26 mg/dL over a period of five days, which was suggestive of acute kidney injury. During that time, the dosage of vancomycin was increased to 20 mg/kg per dose every six hours. The patient continued on the increased dose for 48 hours. At that time, the patient showed serum creatinine level of 2.26 mg/dL [durations of treatments to reaction onset not stated]. The treatment with vancomycin was discontinued for three days. During that time, the patient had also been exposed to IV tobramycin at 800mg daily and ibuprofen at 600mg twice daily for three days. Later, the serum creatinine was normalised to 0.73 mg/dL. The patient was re-initiated on vancomycin therapy. Author comment: "This patient had multiple risks for nephrotoxicity, which reinforces that the use of chronic therapies such as ibuprofen in the setting of aminoglycoside and vancomycin should be avoided because of the increased risk of nephrotoxicity." Fusco NM, et al. Association of vancomycin trough concentration with response to treatment for acute pulmonary exacerbation of cystic fibrosis. Journal of the Pediatric Infectious Diseases Society 6: e103-e108, No. 3, Sep 2017. Available from: URL: http://doi.org/10.1093/jpids/pix043 - USA 803284131 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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