Vancomycin intoxication in a patient with inappropriate antidiuretic hormone syndrome and diarrhea

• Main Authors: Patricia Hidalgo-Collazos, Cristina López González-Cobos, Paula Arrabal-Durán, María Sanjurjo-Sáez
• Format: Article
• Language: English
• Published: Grupo Aula Médica 2015-07-01
• Series: Farmacia Hospitalaria
• Subjects: Intoxication; Vancomycin; Syndrome; Secretion; Inadequate hormone; ; Antidiuretic; ; Diarrhea
• Online Access: http://www.aulamedica.es/fh/pdf/8095.pdf

Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L) to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of resistance by subtherapeutic levels. Nephrotoxicity for vancomycin monotherapy at standard doses according to pathogen and typical regimens (usual dose: 15-20 mg/kg/12 h) is rare and usually reversible. Moreover, monitoring plasma concentrations allows to achieve concentrations within therapeutic range to allow safe and effective drug use. The renal hypoperfusion can cause pre-renal damage, resulting in elevated levels of serum creatinine, resulting in decreased antibiotic elimination and nephrotoxicity. We report a case of unexpected vancomycin nephrotoxicity in a patient with syndrome Inappropriate antidiuretic hormone secretion associated paraneoplastic