VANCOMYCIN SERUM LEVELS AND TOXICITY IN CHRONIC-HEMODIALYSIS PATIENTS WITH STAPHYLOCOCCUS-AUREUS BACTEREMIA

  • 1 January 1983
    • journal article
    • research article
    • Vol. 20  (2) , 85-88
Abstract
The pharmacokinetics and toxicity of 6 wk courses of vancomycin were assessed prospectively in 12 chronic hemodialysis patients who had 17 episodes of S. aureus bacteremia. Patients were treated with 1 g doses of vancomycin at weekly intervals for 6 wk. Peak serum vancomycin concentrations ranged from 5.5-40.0 .mu.g/ml and trough concentrations were 1.0-12.0 .mu.g/ml at the time of the second dose. No patient demonstrated important drug accumulation at the time of the 5th dose. Pure tone audiometry demonstrated no auditory toxicity. Flushing and pruritis (2 patients) were the only adverse effects noted. In 16 episodes blood cultures were sterilized within 48 h of therapy. This investigation demonstrates that in chronic hemodialysis patients with S. aureus bacteremia vancomycin is a safe and microbiologically effective antimicrobial agent. Peak and trough serum concentrations vary widely when 1 g doses are given at 1 wk intervals, and thus it is recommended that concentrations be measured for each patient, particularly if the minimum bactericidal concentration of vancomycin for the clinical isolate is > 1.0 .mu.g/ml.

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