International Journal of Critical Illness and Injury Science

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 8  |  Issue : 4  |  Page : 194--200

Assessment of acute kidney injury in neurologically and traumatically injured intensive care patients receiving large vancomycin doses


Casey C May1, Beth L Erwin2, Margaret Childress2, Josh Cortopassi2, Garrett Curtis2, Tyson Kilpatrick2, Jennifer Taylor2, Bonnie Vance2, Doug Wylie2 
1 Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
2 Department of Pharmacy, University of Alabama at Birmingham Medical Center, Birmingham, AL, USA

Correspondence Address:
Dr. Casey C May
Department of Pharmacy, The Ohio State University Wexner Medical Center, Room 368, Doan Hall, 410 W 10th Ave., Columbus, OH 43210
USA

Background: Previous reports note that in a mixed patient population, vancomycin doses >4 g/day are associated with increased rates of acute kidney injury (AKI). Objective: The objective of the study is to determine if vancomycin regimens >4 g/day are associated with a higher incidence of AKI in neurocritical care unit (NCCU) and trauma/burn Intensive Care Unit (TBICU) patients. Materials and Methods: This single-centered, retrospective study enrolled adult patients initiated on vancomycin in the NCCU and TBICU at an academic medical center during 2016. Based on maximum steady-state dose exposure, patients were separated into two groups: ≤4 g/day and >4 g/day. The primary outcome of incidence of AKI was defined by the AKI Network criteria. Results: A total of 284 patients were screened for eligibility; 165 patients met inclusion criteria, 98 patients received ≤4 g/day and 67 patients received >4 g/day. The >4 g/day group had a lower mean age (32.6±11.1 vs. 47.8±16.2, P < 0.001), included more male patients (81% vs. 60%, P = 0.008), were more often treated for a central nervous system infection (31% vs. 11%, P = 0.001), had, on average, more concomitant use of nephrotoxic drugs (2.2±1.2 vs. 1.8±0.9, P = 0.02) and had a higher exposure to contrast (94% vs. 79%, P < 0.001). The primary outcome of AKI occurred in 14 patients receiving ≤4 g/day and five patients receiving >4 g/day which was not statistically significant (14% vs. 7%, P = 0.22). Conclusions: Our results indicate that administering >4 g/day of vancomycin to achieve therapeutic vancomycin troughs does not appear to lead to an increased incidence of AKI in a mixed NCCU and TBICU population.


How to cite this article:
May CC, Erwin BL, Childress M, Cortopassi J, Curtis G, Kilpatrick T, Taylor J, Vance B, Wylie D. Assessment of acute kidney injury in neurologically and traumatically injured intensive care patients receiving large vancomycin doses.Int J Crit Illn Inj Sci 2018;8:194-200


How to cite this URL:
May CC, Erwin BL, Childress M, Cortopassi J, Curtis G, Kilpatrick T, Taylor J, Vance B, Wylie D. Assessment of acute kidney injury in neurologically and traumatically injured intensive care patients receiving large vancomycin doses. Int J Crit Illn Inj Sci [serial online] 2018 [cited 2019 Mar 20 ];8:194-200
Available from: http://www.ijciis.org/article.asp?issn=2229-5151;year=2018;volume=8;issue=4;spage=194;epage=200;aulast=May;type=0