Vancomycin Cumulative

Figure 2.17 Cumulative vancomycin release of single-layer coatings as a function of antibiotic concentration. (Reproduced from ref. 12, with permission.)...

A study in 10 patients with small cell bronchogenic carcinoma taking methotrexate found that when they were also given a range of oral anti-in-feetives (paromomycin, vancomycin, polymyxin B, nystatin) the urinary recovery of methotrexate was reduced by over one-third (from 69% to 44%). The paromomycin was believed to have been responsible. In another study the concurrent use of neomycin 500 mg four times a day for 3 days reduced the methotrexate AUC and the 72-hour cumulative excretion by 50%. In contrast, the same report suggests that kanamycin can increase the absorption of methotrexate, but no details are given. 

In a retrospective case-control study of 134 patients who received 139 courses of intravenous colistin for at least 24 hours the cumulative incidence of nephrotoxicity was 73/139 (52%) [108. Independent susceptibility factors were old age, prolonged duration of intravenous cohstin, and concomitant vancomycin therapy. 

In a retrospective cohort study of 80 patients received vancomycin given either as an intermittent infusion or as a continuous infusion with a similar cumulative dose the prevalence of nephrotoxicity was similar in the two groups (16%) [94 ]. 

---