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Case Rep Pediatr. 2011;2011:678724. doi: 10.1155/2011/678724. Epub 2012 Jan 29.

Successful utilization of high-flux hemodialysis for treatment of vancomycin toxicity in a child.

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  • 1Pediatric Intensive Care Unit, Section of Critical Care Medicine, Children's Hospital Colorado and University of Colorado at Denver, 13123 East 17th Avenue, Mail Stop 8414, Aurora, CO 80045, USA.


Vancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity. We report a case of a pediatric patient who developed vancomycin toxicity and associated oliguric renal failure who was treated effectively with high-flux hemodialysis for vancomycin toxicity, clearing serum concentrations of vancomycin by over 75% in only 6 hours (213.2 mcg/mL to 51.8 mcg/mL) with subsequent return to baseline renal function and without adverse sequelae. While not historically considered a viable option for drug removal in cases of toxicity, new high-flux hemodialysis techniques can remove significant percentages of vancomycin in short periods of time.

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