Korean J Clin Pharm.  2017 Mar;27(1):22-29. 10.24304/kjcp.2017.27.1.22.

Risk Factors for Vancomycin-Associated Nephrotoxicity in Elderly Patients

• Kim HN
• Kim HS
• Lee YH
• Lee KJ
• Shin SW
• Park SC
• Lee YJ

• KMID: 2377536
• DOI: http://doi.org/10.24304/kjcp.2017.27.1.22

Abstract

OBJECTIVE
Infection is very common in the elderly, so there is a high prevalence of antibiotics use among this population. Especially, due to the emergence of resistant bacteria, the use of vancomycin is growing. The purpose of this study was to evaluate risk factors associated with vancomycin-induced nephrotoxicity in elderly patients.
METHODS
The subjects of this study were patients over 18 years old who received intravenous vancomycin in a general hospital located in Gangneung-si, Korea between August 1, 2013 and July 31, 2015. Data collection regarding vancomycin use and baseline characteristics was conducted using computerized hospital database. Logistic regression analysis was used to identify risk factors associated with vancomycin-induced nephrotoxicity.
RESULTS
A total of 290 patients were finally included, and 191(66%) out of these patients were age 65 or older. The incidence of vancomycin-induced nephrotoxicity was 11.0%, 12.6%, and 7.0% in the all adult patients, the elderly patients, and the non-elderly patients, respectively. There were significant differences in comorbidities between patients with nephrotoxicity and patients without nephrotoxicity in the all adult patients, and there were significant differences in vancomycin duration, comorbidities, and number of nephrotoxic agents between patients with nephrotoxicity and patients without nephrotoxicity in the elderly patients. However, according to the logistic regression analysis, there was no significant risk factor that increases the incidence of vancomycin-induced nephrotoxicity in all three age groups.
CONCLUSION
There were no differences in risk factors that increase the incidence of vancomycin-induced nephrotoxicity between all adult patients, elderly patients, and non-elderly patients. Further studies with larger sample sizes to identify risk factors associated with vancomycin-induced nephrotoxicity in the elderly to improve the outcome of pharmacotherapy are required.

Keyword

Risk factors; acute kidney injury; vancomycin; nephrotoxicity; elderly

MeSH Terms

Acute Kidney Injury
Adult
Aged*
Anti-Bacterial Agents
Bacteria
Comorbidity
Data Collection
Drug Therapy
Hospitals, General
Humans
Incidence
Korea
Logistic Models
Prevalence
Risk Factors*
Sample Size
Vancomycin
Anti-Bacterial Agents
Vancomycin