Cancer patient vancomycin

Vancomycin is an especially useful antibiotic for treating infections in cancer patients on chemotherapy and renal patients on dialysis. Uniike mammalian celis, bacterial cells are surrounded by a fairly rigid celi wall, which is crucial to the bacterium s survivai. Vancomycin kills bacteria by interfering with their cell wall synthesis. 

Numerous risk factors have been identified for infection with vancomycin-resistant enterococci. In one study the severity of mucositis in cancer patients was significantly associated with vancomycin-resistant enterococci (100). Previous vancomycin therapy was also believed to be a risk factor. However, a meta-analysis concluded that the reported strong association between vancomycin treatment and hospital-acquired vancomycin-resistant enterococci results from selection bias, confounding by duration of hospitalization, and publication bias (101). 

Intravenous vancomycin 30 0 mg/kg/day, divided every 6 hours, was given tol67 infants and children without cancer and 42 cancer patients aged 3 months to 17.5... 

Kuehnert MJ, Jernigan JA, Pullen AL, Rimland D, Jarvis WR. Association between mucositis severity and vancomycin-resistant enterococcal bloodstream infection in hospitalized cancer patients. Infect Control Hosp Epidemiol 1999 20(10) 660-3. 

Cimino MA, Rotstein CR, Slaughter RL, Emrich LJ, Relationship of serum antibiotic concentrations to nephrotoxicity in cancer patients receiving concurrent aminoglycoside and vancomycin therapy, Am J Med, 1987,83 1091-97. 

The nephrotoxicity of various combinations of antibiotics was assessed in 171 cancer patients (139 treated with a combination of aminoglycoside with penicillin or cephalosporin 32 treated with amphotericin B or vancomycin with other antibacterials). The highest nephrotoxicity (based on changes in urea and electrolytes) was found in patients treated with amphotericin B with an aminoglycoside and a cephalosporin. ... 

Feld R. Vancomycin as part of initial empirical antibiotic therapy for febrile neutropenia in patients with cancer Pros and cons. Qin Infect Dis 1999 29 503-507. 

Cometta A, Kem WV, De Bock R, et al. Vancomycin versus placebo for treating persistent fever in patients with neutropenic cancer receiving piperacilUn-tazobactam monotherapy. Qin Infect Dis 2003 37 382-289. 

Comparative studies In 40 patients with cancers and probably or definite catheter-related bloodstream infections who were given daptomycin 6 mg/kg/day, compared with 40 historical-matched control patients treated with vancomycin, there was no difference in adverse events or withdrawals [I34M] However, nausea, vomiting, dizziness, a raised CK activity and rashes were more frequent with daptomycin and pruritus and erythema with vancomycin. 

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