Which aminoglycoside antibiotic is the most nephrotoxic?
The following rank order of nephrotoxicity has been reported, from most toxic to least toxic: neomycin > gentamicin ≥ tobramycin ≥ amikacin ≥ netilmicin > streptomycin .
Which aminoglycoside can be nephrotoxic?
Aminoglycosides released from lysosomes could, however, act indirectly as nephrotoxins. In this connection, gentamicin was shown to chelate mitochondrial iron, forming a very oxidant Fe(II)-gentamicin complex capable of causing hair cell death (100).
Is Vanco nephrotoxic?
Vancomycin is the drug of choice for methicillin‐resistant Staphylococcus aureus (MRSA)1 but has been associated with significant nephrotoxicity.
Is vancomycin an aminoglycoside?
Another useful attribute of aminoglycosides is their synergism with antibiotics that inhibit bacterial cell wall biosynthesis, such as β-lactams and vancomycin. Finally, aminoglycosides have relatively predictable pharmacokinetic characteristics that allow them to be dosed to minimize their inherent toxicities.
Is vancomycin contraindicated in renal failure?
Accumulation of vancomycin in patients with renal insufficiency may therefore occur, and this may lead to toxic side effects if dosage is not modified according to the degree of renal failure.
Does vancomycin cause kidney failure?
The risk of vancomycin-induced acute kidney injury increases with plasma vancomycin levels. Vancomycin-induced acute kidney injury is histologically characterized by acute interstitial nephritis and/or acute tubular necrosis.
Is vancomycin a cephalosporin?
Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of serious staphylococcal infections. It is the alternative therapy of choice when the penicillins and cephalosporins cannot be used.
Can vancomycin cause ototoxicity?
Ototoxicity is a less frequently described adverse effect of vancomycin and has not been as readily demonstrated, however vestibular damage and/or cochlear damage associated with tinnitus and sensorineural hearing loss has been reported in humans after administration of vancomycin [9–14].
Which antibiotics are less nephrotoxic?
Alternative first-line drugs for treating MRSA include teicoplanin, which has been found to have a lower risk of nephrotoxicity than vancomycin, and daptomycin, which is currently the only antibiotic to have shown noninferiority to vancomycin in the treatment of MRSA.
Do vancomycin and aminoglycosides have synergistic nephrotoxicity?
Both preclinical studies and human data support the potential synergistic nephrotoxicity of vancomycin and aminoglycosides.
Can vancomycin cause nephrotoxicity in children?
Vancomycin-induced nephrotoxicity: pediatric studies Studies on vancomycin-induced renal toxicity have been performed mostly in the adult population. There are few pediatric clinical trials and where available they are mostly of retrospective design [Goren et al. 1989; Nahata, 1987].
What is the mechanism of vancomycin-induced nephrotoxicity?
Mechanisms of vancomycin-induced nephrotoxicity Although the mechanism underlying renal toxicity from vancomycin is not fully understood, experimental studies supported proinflammatory oxidation, mitochondrial dysfunction and cellular apoptosis as the principal modes of injury.
What is the pathophysiology of vancomycin toxicity?
Although the mechanism underlying renal toxicity from vancomycin is not fully understood, experimental studies supported proinflammatory oxidation, mitochondrial dysfunction and cellular apoptosis as the principal modes of injury.