Vancomycin Exposure and Acute Kidney Injury Outcome: A Snapshot From the CAMERA2 Study

Jiajun Liu; Steven Y C Tong; Joshua S Davis; Nathaniel J Rhodes; Marc H Scheetz; CAMERA2 Study Group

doi:10.1093/ofid/ofaa538

Vancomycin Exposure and Acute Kidney Injury Outcome: A Snapshot From the CAMERA2 Study

Open Forum Infect Dis. 2020 Nov 4;7(12):ofaa538. doi: 10.1093/ofid/ofaa538. eCollection 2020 Dec.

Authors

Jiajun Liu^{1

2

3}, Steven Y C Tong^{4

5}, Joshua S Davis⁵, Nathaniel J Rhodes^{1

2

3}, Marc H Scheetz^{1

2

3}; CAMERA2 Study Group

Collaborators

CAMERA2 Study Group:
Nick Anagostou, David Andresen, Sophia Archuleta, Narin Bak, Alan Cass, Mark Chatfield, Alan Cheng, Jane Davies, Joshua Davis, Yael Dishon, Ravindra Dotel, Patricia Ferguson, Hong Foo, Vance Fowler, Niladri Ghosh, Timothy Gray, Stephen Guy, Natasha Holmes, Benjamin Howden, Sandra Johnson, Shirin Kalimuddin, David Lye, Stephen McBride, Genevieve McKew, Niamh Meagher, Jane Nelson, Matthew O'Sullivan, David Paterson, Mical Paul, David Price, Anna Ralph, Matthew Roberts, Owen Robinson, Ben Rogers, Naomi Runnegar, Simon Smith, Archana Sud, Steven Tong, Adrian Tramontana, Sebastian Van Hal, Genevieve Walls, Morgyn Warner, Dafna Yahav, Barnaby Young

Affiliations

¹ Midwestern University Chicago College of Pharmacy, Downers Grove, Illinois, USA.
² Northwestern Memorial Hospital, Chicago, Illinois, USA.
³ Midwestern University Chicago College of Pharmacy Pharmacometrics Center of Excellence, Downers Grove, Illinois, USA.
⁴ Victorian Infectious Diseases Service, The Royal Melbourne Hospital, and Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia.
⁵ Menzies School of Health Research, Charles Darwin University, Darwin, Australia.

Abstract

Among patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia from a prospective randomized clinical trial, acute kidney injury (AKI) rates increased with increasing vancomycin exposure, even within the therapeutic range. AKI was independently more common for the (flu)cloxacillin group. Day 2 vancomycin AUC ≥470 mg·h/L was significantly associated with AKI, independent of (flu)cloxacillin receipt.

Keywords: AUC; MRSA bacteremia; acute kidney injury; combination therapy; nephrotoxicity; pharmacokinetics; toxicodynamics; vancomycin; β-lactam.

Grants and funding

R21 AI149026/AI/NIAID NIH HHS/United States