Drug to Treat Serious Infections May Harm Kids' Kidneys, Study Says

The higher the dose of vancomycin, the greater the risk, researchers found

By Mary Elizabeth Dallas

Tuesday, December 30, 2014

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TUESDAY, Dec. 30, 2014 (HealthDay News) -- Treating children who have drug-resistant bacterial infections with high doses of the antibiotic vancomycin may raise the risk of kidney damage, a new study says.

Researchers said the drug should be used cautiously.

"Our results bear out the difficult balancing act between ensuring the dose is high enough to successfully treat these serious and, at times, life-threatening infections against the small but real risk for kidney damage," said the study's senior investigator, Carlton Lee, a pediatric clinical pharmacist at the Johns Hopkins Children's Center in Baltimore.

"Ultimately, what we really need are new drugs that achieve the same therapeutic effect without taking a toll on the kidneys and other organs," Lee said in a Hopkins news release.

Vancomycin is only used to treat infections that don't respond to other medications. One of these bacteria is MRSA (methicillin-resistant Staphylococcus aureus), which led to new dosing guidelines for the antibiotic in 2009.

At high doses, vancomycin can reach levels in the blood necessary to fight resistant germs and prevent serious complications associated with drug-resistant infections. This study was launched to assess the effects of these high doses on children.

Researchers examined data on 175 children treated with vancomycin between 2009 and 2010. The kids had invasive drug-resistant infections in the skin, bone, heart, lung and brain, or bloodstream infections caused by MRSA. While taking the drug they underwent routine blood tests to assess their kidney function. Fourteen percent developed kidney damage, the study authors found.

The higher the dose of vancomycin, the greater the risk for kidney damage, the researchers reported in the December issue of Annals of Pharmacotherapy.

How long the children were treated with vancomycin also played a role. On average, the children in the study who developed kidney damage were treated with vancomycin for eight days -- twice as long as those who did not have kidney damage.

For each additional day on the drug, the risk of kidney damage increased by 11 percent. Simultaneous use of vancomycin with certain other drugs also raised the risk of kidney damage, the study concluded.

The researchers noted, however, that vancomycin has been used for three decades and can save lives. They added that kidney damage associated with the drug is often reversible once treatment ends.

But they cautioned that newer and safer treatments are needed for drug-resistant bacterial infections in children.

"The results of our study highlight the need for trials that provide pediatric experts with the evidence needed to make informed treatment and dosing decisions, ones that are based on solid data in children rather than on extrapolation from adult patients," study lead author Elizabeth Sinclair, a pediatric clinical pharmacy specialist at Texas Children's Hospital who conducted the research while at Hopkins, said in the news release.

SOURCE: Johns Hopkins Children's Center, news release, Dec. 29, 2014

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