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Review
. 2017 Sep;102(3):459-469.
doi: 10.1002/cpt.726. Epub 2017 Jun 5.

The Nephrotoxicity of Vancomycin

E J Filippone  1   2 , W K Kraft  3 , J L Farber  4
Affiliations
Review

The Nephrotoxicity of Vancomycin

E J Filippone et al. Clin Pharmacol Ther. 2017 Sep.

Abstract

Vancomycin use is often associated with nephrotoxicity. It remains uncertain, however, to what extent vancomycin is directly responsible, as numerous potential risk factors for acute kidney injury frequently coexist. Herein, we critically examine available data in adult patients pertinent to this question. We review the pharmacokinetics/pharmacodynamics of vancomycin metabolism. Efficacy and safety data are discussed. The pathophysiology of vancomycin nephrotoxicity is considered. Risk factors for nephrotoxicity are enumerated, including the potential synergistic nephrotoxicity of vancomycin and piperacillin-tazobactam. Suggestions for clinical practice and future research are given.

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