Nephrotoxicity of vancomycin in patients with methicillin-resistant Staphylococcus aureus bacteraemia

Wan Chen Shen, Yi Chun Chiang, Hsiang Yin Chen, Tso Hsiao Chen, Fang Lan Yu, Chao Hsiun Tang, Yuh Mou Sue

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Aim: Vancomycin and teicoplanin are the two most used glycopeptides for the treatment of methicillin-resistant Staphylococcus aureus (MRSA). Vancomycin is suspected to have more nephrotoxicity but this has not been clearly established. The aim of this study was to assess its nephrotoxicity by a consensus definition of acute kidney injury (AKI): the risk (R), injury (I), failure (F), loss and end-stage renal disease (RIFLE) classification. Methods: Patients with MRSA bacteraemia who were prescribed either vancomycin or teicoplanin between 2003 and 2008 were classified. Patients who developed AKI were classified by RIFLE criteria. Variables such as comorbidities, laboratory data and medical cost information were also obtained from the database. Outcomes determined were: (i) the rate of nephrotoxicity and mortality; and (ii) the association of nephrotoxicity with the length of hospital stay and costs. Results: The study included 190 patients (vancomycin 33, teicoplanin 157). Fifteen patients on vancomycin and 27 patients on teicoplanin developed AKI (P = 0.0004). In the vancomycin group, four, eight and three patients were classified to RIFLE criteria R, I and F, respectively. In the teicoplanin group, 17, nine and one patient were classified to RIFLE criteria R, I and F, respectively. Kaplan-Meier analysis showed significant difference in time to nephrotoxicity for the vancomycin group compared to the teicoplanin group. No significant differences were found between the groups in terms of total mortality, length of hospital stay and costs. Conclusion: The study data suggest that vancomycin is associated with a higher likelihood of nephrotoxicity using the RIFLE classification.

Original languageEnglish
Pages (from-to)697-703
Number of pages7
JournalNephrology
Volume16
Issue number8
DOIs
Publication statusPublished - Nov 2011

Fingerprint

Vancomycin
Methicillin-Resistant Staphylococcus aureus
Bacteremia
Teicoplanin
Length of Stay
Acute Kidney Injury
Hospital Costs
Glycopeptides
Mortality
Kaplan-Meier Estimate
Chronic Kidney Failure
Comorbidity
Databases
Costs and Cost Analysis
Wounds and Injuries

Keywords

  • Acute kidney injury
  • Bacteraemia
  • Hospital cost
  • Staphylococcus aureus
  • Teicoplanin
  • Vancomycin

ASJC Scopus subject areas

  • Nephrology

Cite this

Nephrotoxicity of vancomycin in patients with methicillin-resistant Staphylococcus aureus bacteraemia. / Shen, Wan Chen; Chiang, Yi Chun; Chen, Hsiang Yin; Chen, Tso Hsiao; Yu, Fang Lan; Tang, Chao Hsiun; Sue, Yuh Mou.

In: Nephrology, Vol. 16, No. 8, 11.2011, p. 697-703.

Research output: Contribution to journalArticle

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KW - Bacteraemia

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KW - Teicoplanin

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