INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is a lifesaving support technology for potentially reversible neonatal cardiac and/or respiratory failure. Pharmacological consequences of ECMO-induced haemolysis in neonates are not well understood. CASE REPORT: We report a case report of a full-term neonate treated for congenital diaphragmatic hernia and sepsis with ECMO and with vancomycin. While the population elimination half-life of 7 h was estimated, fitting of the simulated population pharmacokinetic profile to truly observed drug concentration points resulted in the personalized value of 41 h. DISCUSSION: The neonate developed ECMO-induced haemolysis with subsequent acute kidney injury resulting in prolonged drug elimination. Whole blood/serum ratio of 0.79 excluded possibility of direct increase of vancomycin serum concentration during haemolysis. CONCLUSION: Vancomycin elimination may be severely prolonged due to ECMO-induced haemolysis and acute kidney injury, while hypothesis of direct increase of vancomycin levels by releasing the drug from blood cells during haemolysis has been disproved.

• Klíčová slova
• ECMO, acute kidney injury, haemolysis, neonate, pharmacokinetics, vancomycin,
• MeSH
• hemolýza MeSH
• lidé MeSH
• mimotělní membránová oxygenace * škodlivé účinky   MeSH
• novorozenec MeSH
• respirační insuficience * MeSH
• vankomycin škodlivé účinky   MeSH
• vrozená brániční kýla * MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• vankomycin MeSH

Acute kidney injury is a common complication in critically ill patients with sepsis and/or septic shock. Further, some essential antimicrobial treatment drugs are themselves nephrotoxic. For this reason, timely diagnosis and adequate therapeutic management are paramount. Of potential acute kidney injury (AKI) biomarkers, non-protein-coding RNAs are a subject of ongoing research. This review covers the pathophysiology of vancomycin and gentamicin nephrotoxicity in particular, septic AKI and the microRNAs involved in the pathophysiology of both syndromes. PubMED, UptoDate, MEDLINE and Cochrane databases were searched, using the terms: biomarkers, acute kidney injury, antibiotic nephrotoxicity, sepsis, miRNA and nephrotoxicity. A comprehensive review describing pathophysiology and potential biomarkers of septic and toxic acute kidney injury in septic patients was conducted. In addition, five miRNAs: miR-15a-5p, miR-192-5p, miR-155-5p, miR-486-5p and miR-423-5p specific to septic and toxic acute kidney injury in septic patients, treated by nephrotoxic antibiotic agents (vancomycin and gentamicin) were identified. However, while these are at the stage of clinical testing, preclinical and clinical trials are needed before they can be considered useful biomarkers or therapeutic targets of AKI in the context of antibiotic nephrotoxicity or septic injury.

• Klíčová slova
• acute kidney injury, gentamicin, miRNA, nephrotoxicity, sepsis, vancomycin,
• MeSH
• akutní poškození ledvin chemicky indukované   diagnóza   etiologie   patofyziologie   MeSH
• antibakteriální látky škodlivé účinky   terapeutické užití   MeSH
• biologické markery analýza   MeSH
• gentamiciny škodlivé účinky   terapeutické užití   MeSH
• ledviny účinky léků   patofyziologie   MeSH
• lidé MeSH
• mikro RNA analýza   MeSH
• sepse komplikace   diagnóza   farmakoterapie   patofyziologie   MeSH
• vankomycin škodlivé účinky   terapeutické užití   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antibakteriální látky MeSH
• biologické markery MeSH
• gentamiciny MeSH
• mikro RNA MeSH
• vankomycin MeSH

Vancomycin is currently the drug of choice in meticillin-resistant Staphylococcus aureus (MRSA) infection. It is also used prophylactically in some situations in which the patient is at risk for endocarditis. It is often used in combination with other antibacterials in the treatment of endocarditis and is a potential nephrotoxin. Various consensus guidelines differ in their interpretation of vancomycin plasma concentrations. This paper describes a case of a 72-years old Caucasian female patient, who developed significant renal impairment when prescribed vancomycin in combination with penicillin for the treatment of endocarditis, caused by Streptococcus pneumoniae.

• MeSH
• antibakteriální látky škodlivé účinky   MeSH
• endokarditida farmakoterapie   MeSH
• hodnoty glomerulární filtrace účinky léků   MeSH
• ledviny účinky léků   patofyziologie   MeSH
• lidé MeSH
• senioři MeSH
• vankomycin škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• antibakteriální látky MeSH
• vankomycin MeSH

The nephrotoxicity of various combinations of antibiotics--aminoglycosides, cephalosporins, vancomycin, amphotericin B--in 171 oncologic patients is described. The most nephrotoxic combination seems to be cefotaxime plus gentamicin, ceftriaxone plus amikacin and amphotericin B with cephalosporin, vancomycin or aminoglycoside. Less toxic was netilmicin with penicillin or cephalosporin, and vancomycin.

• MeSH
• amfotericin B škodlivé účinky   MeSH
• aminoglykosidy MeSH
• antibakteriální látky škodlivé účinky   MeSH
• cefalosporiny škodlivé účinky   MeSH
• kombinovaná farmakoterapie škodlivé účinky   MeSH
• ledviny účinky léků   MeSH
• lidé MeSH
• nádory komplikace   MeSH
• retrospektivní studie MeSH
• vankomycin škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• amfotericin B MeSH
• aminoglykosidy MeSH
• antibakteriální látky MeSH
• cefalosporiny MeSH
• vankomycin MeSH