In Vivo and In Vitro Assessment of Vancomycin-Induced Nephrotoxicity

Vancomycin (VAN), a glycopeptide antibiotic introduced into clinical use in 1956, is effective against a variety of gram-positive organisms but has been associated with renal impairment in a small proportion of patients. Farber and Moellering (1983) estimated that 5% of patients treated with VAN alone exhibited signs of renal impairment whereas 35% of patients receiving VAN concurrently with an aminoglycoside were so affected, suggesting that these antibiotics may act synergistically in producing renal dysfunction. In a report of 50 patients, Sorrell and Collignon (1985) described four with renal dysfunction who received concomitant therapy with VAN and an aminoglycoside for at least 4 days. Twenty-four patients treated with VAN in combination with an aminoglycoside and 12 patients treated with VAN alone showed no signs of renal dysfunction.