The association between vancomycin trough concentrations and acute kidney injury in the neonatal intensive care unit

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Abstract

Background: Vancomycin has recently gained popularity as an empiric therapy for late onset sepsis in the NICU. Changes in resistance patterns in common organisms has resulted in targeting higher trough concentrations of vancomycin. Consequently, an increase in vancomycin associated nephrotoxicity has been speculated. The objective of this study is to compare the incidence of acute kidney injury (AKI) in neonates with serum vancomycin trough concentrations less than 10 mg/L, 10-15 mg/L, or greater than 15 mg/L. Methods: A retrospective chart review of patients in the neonatal intensive care unit (NICU) was conducted to determine the incidence of AKI in neonates receiving vancomycin. Results: The overall incidence of AKI was 2.7%. Comparison of the incidence of AKI in the three groups using Mantel-Haenszel Chi-Square test showed a statistically significant association between increasing vancomycin trough concentration and incidence of AKI. Conclusion: There is a low incidence of AKI in neonates receiving vancomycin. However, there is a positive correlation between increasing vancomycin trough concentrations and an increasing serum creatinine.

Original languageEnglish (US)
Article number50
JournalBMC Pediatrics
Volume17
Issue number1
DOIs
StatePublished - Feb 11 2017

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Neonatal Intensive Care Units
Vancomycin
Acute Kidney Injury
Incidence
Newborn Infant
Chi-Square Distribution
Serum
Creatinine
Sepsis

Keywords

  • AKI, Nephrotoxicity
  • Prematurity
  • Vancomycin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "The association between vancomycin trough concentrations and acute kidney injury in the neonatal intensive care unit",
abstract = "Background: Vancomycin has recently gained popularity as an empiric therapy for late onset sepsis in the NICU. Changes in resistance patterns in common organisms has resulted in targeting higher trough concentrations of vancomycin. Consequently, an increase in vancomycin associated nephrotoxicity has been speculated. The objective of this study is to compare the incidence of acute kidney injury (AKI) in neonates with serum vancomycin trough concentrations less than 10 mg/L, 10-15 mg/L, or greater than 15 mg/L. Methods: A retrospective chart review of patients in the neonatal intensive care unit (NICU) was conducted to determine the incidence of AKI in neonates receiving vancomycin. Results: The overall incidence of AKI was 2.7{\%}. Comparison of the incidence of AKI in the three groups using Mantel-Haenszel Chi-Square test showed a statistically significant association between increasing vancomycin trough concentration and incidence of AKI. Conclusion: There is a low incidence of AKI in neonates receiving vancomycin. However, there is a positive correlation between increasing vancomycin trough concentrations and an increasing serum creatinine.",
keywords = "AKI, Nephrotoxicity, Prematurity, Vancomycin",
author = "Vidit Bhargava and Michael Malloy and Rafael Fonseca",
year = "2017",
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doi = "10.1186/s12887-017-0777-0",
language = "English (US)",
volume = "17",
journal = "BMC Pediatrics",
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AU - Bhargava, Vidit

AU - Malloy, Michael

AU - Fonseca, Rafael

PY - 2017/2/11

Y1 - 2017/2/11

N2 - Background: Vancomycin has recently gained popularity as an empiric therapy for late onset sepsis in the NICU. Changes in resistance patterns in common organisms has resulted in targeting higher trough concentrations of vancomycin. Consequently, an increase in vancomycin associated nephrotoxicity has been speculated. The objective of this study is to compare the incidence of acute kidney injury (AKI) in neonates with serum vancomycin trough concentrations less than 10 mg/L, 10-15 mg/L, or greater than 15 mg/L. Methods: A retrospective chart review of patients in the neonatal intensive care unit (NICU) was conducted to determine the incidence of AKI in neonates receiving vancomycin. Results: The overall incidence of AKI was 2.7%. Comparison of the incidence of AKI in the three groups using Mantel-Haenszel Chi-Square test showed a statistically significant association between increasing vancomycin trough concentration and incidence of AKI. Conclusion: There is a low incidence of AKI in neonates receiving vancomycin. However, there is a positive correlation between increasing vancomycin trough concentrations and an increasing serum creatinine.

AB - Background: Vancomycin has recently gained popularity as an empiric therapy for late onset sepsis in the NICU. Changes in resistance patterns in common organisms has resulted in targeting higher trough concentrations of vancomycin. Consequently, an increase in vancomycin associated nephrotoxicity has been speculated. The objective of this study is to compare the incidence of acute kidney injury (AKI) in neonates with serum vancomycin trough concentrations less than 10 mg/L, 10-15 mg/L, or greater than 15 mg/L. Methods: A retrospective chart review of patients in the neonatal intensive care unit (NICU) was conducted to determine the incidence of AKI in neonates receiving vancomycin. Results: The overall incidence of AKI was 2.7%. Comparison of the incidence of AKI in the three groups using Mantel-Haenszel Chi-Square test showed a statistically significant association between increasing vancomycin trough concentration and incidence of AKI. Conclusion: There is a low incidence of AKI in neonates receiving vancomycin. However, there is a positive correlation between increasing vancomycin trough concentrations and an increasing serum creatinine.

KW - AKI, Nephrotoxicity

KW - Prematurity

KW - Vancomycin

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