Nephrotoxicity in Recipients of Vancomycin vs. Vancomycin with Vitamin C
SaagarAkundi, Young R. Lee, Greg K. Perry, David S. Fike, Sofia Mnjoyan

Background: Nephrotoxicity has been associated with high dose vancomycin, prolonged use, & concomitant nephrotoxic agents. The mechanism of vancomycininduced nephrotoxicity (VIN) is unclear, but may occur due to free radical formation and consequent oxidative damage. Vitamin C has been suggested to reduce renal oxidative stress. This study will determine whether the administration of vitamin C with vancomycin is associatedwith less VIN. Methods: An observational retrospective case-cohort study was conducted on patients admitted to a 522-bed medical center between October 2010 and August 2013. Subjects included were grouped by treatment received - vitamin C with vancomycin or vancomycin alone. Patients were excluded if they had received amphotericin B, antineoplastic agents, calcineurin inhibitors, or antifolates; had a history of renal calculi, dialysis or renal replacement therapy, and renal transplantation; were pregnant; or were prisoners/wards of the state. Results: The incidence of VIN was not significantly different regardless of vitamin C administration in patients receiving vancomycin. However, vitamin C was associated with reduced odds of VIN by 62.3% (p=0.029). Conclusion: Vitamin C administration appears likely to decrease the incidence of VIN.Further research, using experimental design, is warranted to determine if vitamin C prevents VIN.

Full Text: PDF     DOI: 10.15640/ijmp.v3n2a1