Vancomycin toxicity in neonates: a review of the evidence.

Curr Opin Infect Dis

aUniversity of Liverpool, Liverpool bSt George's, University of London, London, UK.

Published: June 2016

Purpose Of Review: Vancomycin is a first-line agent in the treatment of serious Gram-positive infections in the neonatal population. The published evidence on vancomycin toxicity in neonates is limited. This review summarizes preclinical studies and clinical trials describing vancomycin toxicity. We discuss proposed pathophysiology and summarize evidence supporting dose-response relationships, genetic and environmental determinants, and consider future research required to further define vancomycin toxicity.

Recent Findings: Current dosing regimens for vancomycin result in subtherapeutic levels in a large proportion of patients. Higher daily doses have been proposed, which have led to concerns regarding increased toxicity. Nephrotoxicity occurs in 1-9% of neonates receiving currently recommended doses. The incidence is highest in those receiving concomitant nephrotoxic drugs. Vancomycin-associated ototoxicity is rare in patients of all ages. Exposure-toxicity relationships in relation to nephrotoxicity and ototoxicity have not been clearly defined in neonates receiving vancomycin.

Summary: Current evidence supports the favourable safety profile of vancomycin in neonates. Further studies that address safety concerns relating to high-dose intermittent dosing regimens are needed. Such studies must include robust and standardized definitions of renal and hearing impairment, and include follow-up of sufficient length to establish the long-term implications of experimental findings.

Download full-text PDF

Source
http://dx.doi.org/10.1097/QCO.0000000000000263DOI Listing

Publication Analysis

Top Keywords

vancomycin toxicity
12
toxicity neonates
8
dosing regimens
8
neonates receiving
8
vancomycin
7
neonates
5
neonates review
4
evidence
4
review evidence
4
evidence purpose
4

Similar Publications

Vancomycin-resistant Staphylococcus aureus endangers Egyptian dairy herds.

Sci Rep

December 2024

Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, SAR, China.

The emergence of pandrug-resistant (PDR) and extensive drug-resistant (XDR) methicillin-resistant and vancomycin-resistant Staphylococcus aureus (MRSA and VRSA) isolates from bovine milk samples along with biofilm formation ability and harboring various virulence genes complicates the treatment of bovine mastitis and highlights the serious threat to public health. This study investigated for the first time the frequency, antimicrobial resistance profiles, biofilm-forming ability, virulence factors, spa and staphylococcal cassette chromosome mec (SCCmec) types of MRSA and VRSA isolated from clinical and subclinical bovine mastitis in Egypt. A total of 808 milk samples were collected from each quarter of 202 dairy animals, including 31 buffaloes and 171 cattle.

View Article and Find Full Text PDF

The threat posed by bacteria resistant to common antibiotics creates an urgent need for novel antimicrobials. Non-ribosomal peptide natural products that bind Lipid II, such as vancomycin, represent a promising source for such agents. The fungal defensin plectasin is one of a family of ribosomally produced miniproteins that exert antimicrobial activity via Lipid II binding.

View Article and Find Full Text PDF

Antimicrobial resistance in methicillin-resistant (MRSA) is a major global health challenge. This study reports the design and synthesis of novel phenyltriazole derivatives as potential anti-MRSA agents. The new scaffold replaces the thiazole core with a 1,2,3-triazole ring, enhancing antimicrobial efficacy and physicochemical properties.

View Article and Find Full Text PDF

Investigation of adsorption/desorption properties of vancomycin on ionic liquid modified magnetic activated carbon in aqueous solutions and cytotoxicity evaluation of synthesized nanoparticles.

Environ Sci Pollut Res Int

December 2024

Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, 98167-43463, Iran.

Effluents containing antibiotics raise concerns due to their potential to promote or sustain bacterial resistance and disrupt essential cycles and processes critical to aquatic ecology, agriculture, and animal farming. Vancomycin is a glycopeptide antibiotic, recognized as the treatment for cases in which other antibiotics are unsuccessful. The efficient elimination of antibiotics plays a crucial role in managing antibiotic pollution.

View Article and Find Full Text PDF

The broader soil bacterial community responses at ecotoxicologically relevant levels of nano ZnO (nZnO) focussing on co-selection of antibiotic resistance (AR) were investigated. nZnO imposed a stronger influence than the bulk counterpart (bZnO) on antibiotic resistance genes (ARGs) with multidrug resistance (MDR) systems being predominant (63 % of total ARGs). Proliferation of biomarker ARGs especially for last resort antibiotic like vancomycin was observed and Streptomyces hosted multiple ARGs.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!