Pharmacy, Health Sciences & Exercise Science

Event Title

Long-Term Safety Outcomes in Pediatric Patients with Early Acute Kidney Injury After Vancomycin Treatment

Presenter Information

Samantha Christie, Butler University

Document Type

Oral Presentation

Location

Indianapolis, IN

Subject Area

Pharmacy, Health Sciences & Exercise Science

Start Date

11-4-2014 10:15 AM

End Date

11-4-2014 11:45 AM

Description

Background: Vancomycin is a first-line agent for treating pediatric infections caused by methicillin-resistant Staphylococcus aureus. In 2009, the Infectious Disease Society of America recommended that higher vancomycin trough concentrations be targeted due to increasing bacterial resistance. The higher vancomycin doses needed to achieve these trough concentrations resulted in a concern for increased acute kidney injury as vancomycin has been associated with AKI in both children and adults. The objective of this study is to determine the incidence of long-term AKI in children categorized as having AKI within the first 7 days of vancomycin therapy.

Methods: This is a retrospective cohort of 859 patients who received vancomycin for longer than 72 hours in 2007 or 2010 at Riley Hospital for Children. Of 859 patients, 164 patients were categorized as having AKI within the first 7 days of treatment. Previously recorded demographic data, vancomycin trough concentrations, and serum creatinine (SCr) concentrations of this cohort were utilized in this study. Serum creatinine for day 8 of treatment through 10 days past treatment discontinuation, vancomycin trough concentrations, oral intake, urine output, and concomitant nephrotoxins were collected. AKI was defined by an increase in SCr by ≥50% from baseline. Long-term AKI was defined as any AKI beyond the first 7 days of treatment. The primary outcome was the incidence of long-term AKI in patients with ongoing vancomycin treatment.

Results: Data collection is ongoing and results will be presented at the 2014 Butler University URC.

Significance: This study will provide critical information on the long-term incidence of vancomycin-associated AKI potentially allowing for a better optimization of safe and effective pediatric vancomycin dosing.

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Apr 11th, 10:15 AM Apr 11th, 11:45 AM

Long-Term Safety Outcomes in Pediatric Patients with Early Acute Kidney Injury After Vancomycin Treatment

Indianapolis, IN

Background: Vancomycin is a first-line agent for treating pediatric infections caused by methicillin-resistant Staphylococcus aureus. In 2009, the Infectious Disease Society of America recommended that higher vancomycin trough concentrations be targeted due to increasing bacterial resistance. The higher vancomycin doses needed to achieve these trough concentrations resulted in a concern for increased acute kidney injury as vancomycin has been associated with AKI in both children and adults. The objective of this study is to determine the incidence of long-term AKI in children categorized as having AKI within the first 7 days of vancomycin therapy.

Methods: This is a retrospective cohort of 859 patients who received vancomycin for longer than 72 hours in 2007 or 2010 at Riley Hospital for Children. Of 859 patients, 164 patients were categorized as having AKI within the first 7 days of treatment. Previously recorded demographic data, vancomycin trough concentrations, and serum creatinine (SCr) concentrations of this cohort were utilized in this study. Serum creatinine for day 8 of treatment through 10 days past treatment discontinuation, vancomycin trough concentrations, oral intake, urine output, and concomitant nephrotoxins were collected. AKI was defined by an increase in SCr by ≥50% from baseline. Long-term AKI was defined as any AKI beyond the first 7 days of treatment. The primary outcome was the incidence of long-term AKI in patients with ongoing vancomycin treatment.

Results: Data collection is ongoing and results will be presented at the 2014 Butler University URC.

Significance: This study will provide critical information on the long-term incidence of vancomycin-associated AKI potentially allowing for a better optimization of safe and effective pediatric vancomycin dosing.