PMID- 34733068
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220428
IS  - 1078-4497 (Print)
IS  - 1945-337X (Electronic)
IS  - 1078-4497 (Linking)
VI  - 38
IP  - 10
DP  - 2021 Oct
TI  - Comparison of Adverse Events With Vancomycin Diluted in Normal Saline vs Dextrose 
      5.
PG  - 468-472
LID - 10.12788/fp.0193 [doi]
AB  - BACKGROUND: IV vancomycin is widely used for infections caused by Gram-positive 
      bacteria; however, nephrotoxicity is commonly associated with its use. Clinical 
      trials have shown an increased incidence of acute kidney injury (AKI) using 
      normal saline (NS) for fluid resuscitation. This study evaluated differences in 
      AKI and other patient outcomes associated with vancomycin diluted in NS compared 
      with dextrose 5% in water (D5W). METHODS: This retrospective cohort study 
      conducted at a single US Department of Veterans Affairs hospital included 
      veterans who received vancomycin for at least 48 hours between July 1, 2015 and 
      June 30, 2020. This study compared adverse events (AEs) of patients receiving 
      vancomycin diluted in either NS or D5W. The primary outcome was incidence of AKI. 
      Secondary outcomes included incidence of hyperglycemia, hyperchloremia, 
      hypernatremia, metabolic acidosis, in-hospital mortality, and 30-day 
      posthospitalization mortality. RESULTS: The study included 123 patients in each 
      group (N = 246). The percentage of AKI was 22.8% in the D5W group compared with 
      14.6% the NS group (P = .14). There were no significant differences in the rates 
      of hyperglycemia, hyperchloremia, hypernatremia, or metabolic acidosis between 
      the 2 groups. In-hospital mortality and 30-day posthospitalization mortality were 
      similar between the groups. CONCLUSIONS: This study comparing the AEs of IV 
      vancomycin diluted in NS and D5W found no significant differences in AKI or other 
      patient outcomes. These study results do not suggest the crystalloid used to 
      dilute IV vancomycin is associated with differences in nephrotoxicity or other 
      relevant AEs.
CI  - Copyright (c) 2021 Frontline Medical Communications Inc., Parsippany, NJ, USA.
FAU - Ross, Robert C
AU  - Ross RC
AD  - is a Clinical Pharmacy Fellow, is a Pharmacy Resident, is a Pharmacy Resident, 
      and is a Clinical Pharmacy Specialist at the North Florida/South Georgia Veterans 
      Health System in Gainesville, Florida.
FAU - Kelly, Bridgette A
AU  - Kelly BA
AD  - is a Clinical Pharmacy Fellow, is a Pharmacy Resident, is a Pharmacy Resident, 
      and is a Clinical Pharmacy Specialist at the North Florida/South Georgia Veterans 
      Health System in Gainesville, Florida.
FAU - Smith, Rachel M
AU  - Smith RM
AD  - is a Clinical Pharmacy Fellow, is a Pharmacy Resident, is a Pharmacy Resident, 
      and is a Clinical Pharmacy Specialist at the North Florida/South Georgia Veterans 
      Health System in Gainesville, Florida.
FAU - Franck, Andrew J
AU  - Franck AJ
AD  - is a Clinical Pharmacy Fellow, is a Pharmacy Resident, is a Pharmacy Resident, 
      and is a Clinical Pharmacy Specialist at the North Florida/South Georgia Veterans 
      Health System in Gainesville, Florida.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Fed Pract
JT  - Federal practitioner : for the health care professionals of the VA, DoD, and PHS
JID - 9500574
PMC - PMC8560101
COIS- Author disclosures The authors report no actual or potential conflicts of 
      interest with regard to this article.
EDAT- 2021/11/05 06:00
MHDA- 2021/11/05 06:01
PMCR- 2021/10/01
CRDT- 2021/11/04 06:19
PHST- 2021/11/04 06:19 [entrez]
PHST- 2021/11/05 06:00 [pubmed]
PHST- 2021/11/05 06:01 [medline]
PHST- 2021/10/01 00:00 [pmc-release]
AID - fp-38-10-468 [pii]
AID - 10.12788/fp.0193 [doi]
PST - ppublish
SO  - Fed Pract. 2021 Oct;38(10):468-472. doi: 10.12788/fp.0193.