Reporting on Adverse Clinical Events

Abstract

A retrospective single-center cohort study compared the rates of nephrotoxicity in 300 patients who received continuous infusion or intermittent infusion vancomycin for at least 1 week in an outpatient parenteral antimicrobial therapy program. Nephrotoxicity was defined as an increase in serum creatinine greater than 0.5 mg/dL or a 50% increase from baseline for 2 consecutive measurements. Clinical failure was defined as unplanned readmission, extension of therapy, or change in antibiotics. Continuous infusion vancomycin was associated with a 3.22fold lower risk of nephrotoxicity when compared with intermittent infusion (odds ratio = 3.22, 95% confidence interval = 1.10-9.46, P = .027). In addition, there was a significantly slower onset to nephrotoxicity (P = .035). There was no difference between the groups for clinical failure rates (13.5% vs 23.0%; P = .147). The authors concluded that continuous infusion vancomycin was associated with a lower risk of and slower onset to nephrotoxicity than intermittent vancomycin infusion. There was no difference between the groups in clinical failure rates. Vancomycin [Vancomycin] Shakeraneh P et al (WD Kufel, Binghamton University School of Pharmacy and Pharmaceutical Sciences, PO Box 6000, Binghamton, NY 13902-6000; e-mail: wkufel@binghamton.edu) Nephrotoxicity risk and clinical effectiveness of continuous versus intermittent infusion vancomycin among patients in an outpatient parenteral antimicrobial therapy program. Pharmacotherapy 40:357–362 (Apr) 2020