Influence of Vancomycin Infusion Methods on Endothelial Cell Toxicity

Endothelial Cell Toxicity of Vancomycin Infusion Combined with Other Antibiotics

“…Vancomycin infusion has been implicated in cases of phlebitis, thus increasing the number of venipunctures (1,2). Our previous study showed that vancomycin endothelial toxicity depended on the drug concentration and the duration of the infusion but not on pH (3). Indeed, infusion of vancomycin at concentrations over 5 mg/ml induced 50% endothelial cell death over 24 h, confirming the results of previous studies (4,5).…”

“…The availability of HUVEC to test drug solutions for intravenous compatibility is a valuable alternative to animal models, as has been demonstrated by studies which have analyzed antibiotic compatibility and the inflammatory process on HUVEC (15,19). Our results confirm the local toxicity of vancomycin under clinical conditions, with an LD 50 of about 5 mg/ml for 24 h of continuous infusion (3). Although the Infusion Nursing Standards of Practice recommend using a central catheter for vancomycin infusion at concentrations over 5 mg/ml to avoid phlebitis or other complications, a p.i.v.…”

“…Vancomycin requires long-term therapy, which increases the risk of complications, as demonstrated in a previous study where the excess rate of death of endothelial cells reached 100% after 72 h of vancomycin infusion at 5 mg/ml (3). An assessment of the toxicity of vancomycin when combined with other medications should improve vancomycin infusion in hospitals and, thus, reduce endothelial toxicity.…”

Large Cohort Study of Central Venous Catheter Thrombosis during Intravenous Antibiotic Therapy

“…In fact, among our patients, the risk of CRT increased with a high daily dose of vancomycin (median of 3.5 g [interquartile range, 3 to 4 g]) and the duration of vancomycin treatment, and no signs of CRT were observed in patients with Ͻ12 days of treatment. Drouet et al showed in a recent in vitro model that continuous vancomycin infusion induced greater cell toxicity than intermittent infusion at doses higher than 1 g/day (28).…”

Safety of topical vancomycin powder in neurosurgery

“…[830] Purported mechanisms of this venous reaction include irritation due to pH and direct endothelial cell toxicity. [15] Drouet et al . quantitated the lethal dose 50 (LD50) of vancomycin on endothelial cultures and found a dose- and time-dependent relationship.…”