Safety and Efficacy of Strategy to Prevent Drug-Induced Nephrotoxicity in High-Risk Patients
| Status: | Recruiting |
|---|---|
| Conditions: | Arthritis, Pneumonia, Skin and Soft Tissue Infections, Cardiology, Infectious Disease, Orthopedic, Hematology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Dermatology / Plastic Surgery, Hematology, Immunology / Infectious Diseases, Pulmonary / Respiratory Diseases, Rheumatology, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/27/2013 |
| Start Date: | October 2011 |
| Contact: | Joseph Carreno, Pharm.D. |
| Email: | jcarren1@hfhs.org |
| Phone: | 313-916-1088 |
For more than fifty years, vancomycin has been cited as a nephrotoxic agent. Reports of
vancomycin induced kidney injury (a.k.a vancomycin induced nephrotoxicity or VIN), have
waxed and waned throughout the years for various reasons. Recently, VIN has reemerged as a
clinical concern. This may be due to various reasons, including new dosing recommendations
as well as an increased prevalence of risk factors associated with vancomycin induced
nephrotoxicity. This study aims to evaluate a strategy which attempts to reduce kidney
damage from vancomycin use.
Inclusion Criteria:
- Aged 18 years or older
- Receiving intravenous vancomycin for the treatment of healthcare associated
pneumonia, osteomyelitis/septic arthritis, endocarditis/bacteremia, or acute
bacterial skin and skin structure infections
- Expected to receive vancomycin for at least 72 hours and are within the first 72
hours of therapy
- Have at least two or more of the following risk factors for drug-induced
nephrotoxicity: a) receipt high-dose vancomycin therapy (greater than or equal to
four grams per day) b) receipt of vasopressors c) receipt of nephrotoxic drugs (i.e.
aminoglycosides, furosemide, acyclovir, amphotericin b, colistin, and intravenous
contrast dye) d) pre-existing renal dysfunction (i.e. SCr greater than or equal to
1.5 mg/dL).
Exclusion Criteria:
- Pregnancy
- End-stage renal disease
- Receipt of more than 4 grams of vancomycin prior to enrollment on current admission
- Absolute neutrophil count < 1000/mm3
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