Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child

Vancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity. We report a case of a pediatric patient who develop...

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Main Authors: Timothy Stidham, Pamela D. Reiter, Douglas M. Ford, Gary M. Lum, Joseph Albietz
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2011/678724
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author Timothy Stidham
Pamela D. Reiter
Douglas M. Ford
Gary M. Lum
Joseph Albietz
author_facet Timothy Stidham
Pamela D. Reiter
Douglas M. Ford
Gary M. Lum
Joseph Albietz
author_sort Timothy Stidham
collection DOAJ
description Vancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity. We report a case of a pediatric patient who developed vancomycin toxicity and associated oliguric renal failure who was treated effectively with high-flux hemodialysis for vancomycin toxicity, clearing serum concentrations of vancomycin by over 75% in only 6 hours (213.2 mcg/mL to 51.8 mcg/mL) with subsequent return to baseline renal function and without adverse sequelae. While not historically considered a viable option for drug removal in cases of toxicity, new high-flux hemodialysis techniques can remove significant percentages of vancomycin in short periods of time.
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series Case Reports in Pediatrics
spelling doaj-art-bcdd240eed43451084cd262fe9e670812025-08-20T03:23:18ZengWileyCase Reports in Pediatrics2090-68032090-68112011-01-01201110.1155/2011/678724678724Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a ChildTimothy Stidham0Pamela D. Reiter1Douglas M. Ford2Gary M. Lum3Joseph Albietz4Pediatric Intensive Care Unit, Section of Critical Care Medicine, Children's Hospital Colorado and University of Colorado at Denver, 13123 East 17th Avenue, Mail Stop 8414, Aurora, CO 80045, USAPediatric Intensive Care Unit, Department of Pharmacy, Center for Pediatric Medicine, Children's Hospital Colorado and University of Colorado Denver School of Pharmacy, 13123 East 17th Avenue, Campus Box 375, Aurora, CO 80045, USADepartment of Nephrology, University of Colorado at Denver and Children's Hospital Colorado, 13123 East 16th Avenue, Campus Box B328, Aurora, CO 80045, USADepartment of Nephrology, University of Colorado at Denver and Children's Hospital Colorado, 13123 East 16th Avenue, Campus Box B328, Aurora, CO 80045, USAPediatric Intensive Care Unit, Section of Critical Care Medicine, University of Colorado at Denver and Children's Hospital Colorado, 13123 East 17th Avenue, Campus Box B530, Aurora, CO 80045, USAVancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity. We report a case of a pediatric patient who developed vancomycin toxicity and associated oliguric renal failure who was treated effectively with high-flux hemodialysis for vancomycin toxicity, clearing serum concentrations of vancomycin by over 75% in only 6 hours (213.2 mcg/mL to 51.8 mcg/mL) with subsequent return to baseline renal function and without adverse sequelae. While not historically considered a viable option for drug removal in cases of toxicity, new high-flux hemodialysis techniques can remove significant percentages of vancomycin in short periods of time.http://dx.doi.org/10.1155/2011/678724
spellingShingle Timothy Stidham
Pamela D. Reiter
Douglas M. Ford
Gary M. Lum
Joseph Albietz
Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child
Case Reports in Pediatrics
title Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child
title_full Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child
title_fullStr Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child
title_full_unstemmed Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child
title_short Successful Utilization of High-Flux Hemodialysis for Treatment of Vancomycin Toxicity in a Child
title_sort successful utilization of high flux hemodialysis for treatment of vancomycin toxicity in a child
url http://dx.doi.org/10.1155/2011/678724
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AT garymlum successfulutilizationofhighfluxhemodialysisfortreatmentofvancomycintoxicityinachild
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