Prevention of vancomycin induced nephrotoxicity: a review of preclinical data

Eur J Clin Pharmacol. 2013 Apr;69(4):747-54. doi: 10.1007/s00228-012-1406-3. Epub 2012 Sep 21.

Abstract

Purpose: Several strategies have been proposed for the prevention of vancomycin-induced nephrotoxicity. Here, we review available evidence supporting the respective strategies.

Method: Data were collected by searching the Scopus, PubMed, and Medline databases and the Cochrane database of systematic reviews. The key words used as search terms were "vancomycin," "nephrotoxicity", "renal failure," "renal damage," "nephroprotective," "renoprotective", and "prevention." Prospective or retrospective observational animal studies that evaluated the effects of a modality for the prevention of vancomycin-induced nephrotoxicity was included.

Results and conclusion: Animal studies show beneficial effects of various antioxidants, such as erdosteine, vitamin E, vitamin C, N-acetylcysteine, caffeic acid phenethyl ester, and erythropoietin, in the prevention of vancomycin-induced nephrotoxicity. However, before these agents can be used in clinical practice, their potential benefits must be confirmed in future randomized controlled human studies.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / pharmacokinetics
  • Antioxidants / administration & dosage
  • Antioxidants / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Evaluation, Preclinical
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / prevention & control*
  • Tissue Distribution
  • Vancomycin / administration & dosage
  • Vancomycin / adverse effects*
  • Vancomycin / pharmacokinetics

Substances

  • Anti-Bacterial Agents
  • Antioxidants
  • Vancomycin