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Nancy J. Downs, MD; Robert E. Neihart, MD; Jeanette M. Dolezal, PhD; Glenn R. Hodges, MD

Arch Intern Med. 1989;149(8):1777-1781.

Abstract
• Nephrotoxicity related to vancomycin hydrochloride therapy has been reported at overall rates of 7% to 16% and as high as 35% when combined with an aminoglycoside antibiotic. We conducted a prospective study in older men. A group that received vancomycin was compared with a control group to determine the incidence of nephrotoxicity secondary to vancomycin therapy alone and in combination with aminoglycosides, to identify possible risk factors associated with nephrotoxicity, and to determine the incidence of other adverse effects associated with vancomycin use. Nephrotoxicity occurred in 11 (17%) of 66 patients receiving vancomycin and in 3 (5%) of 57 controls overall. Stepwise logistic-regression analysis failed to identify underlying illnesses or concurrent risks that may have contributed to the development of nephrotoxicity associated with vancomycin. Adverse effects, including phlebitis (14%), neutropenia (1%), rash (0%), and red neck syndrome (0%), occurred at rates similar to previous reports.

(Arch Intern Med. 1989;149:1777-1781)

Author Affiliations
From the Medical Service, Veterans Administration Medical Center, Kansas City, Mo (Drs Downs and Hodges); and the Departments of Medicine (Drs Downs, Neihart, and Hodges) and Preventive Medicine (Dr Dolezal), College of Health Sciences, University of Kansas, Kansas City, Kan.

Footnotes
Accepted for publication November 8,1988.

Presented at the annual meeting of the American College of Physicians, Kansas Chapter, September 12, 1987, Wichita.

Reprint requests to Chief of Staff (11), Veterans Administration Medical Center, 4801 Linwood Blvd, Kansas City, MO 64128 (Dr Hodges).

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