What this study adds:
- Increased kidney injury was confirmed when flucloxacillin was added to
vancomycin as determined by multiple kidney injury biomarkers in a
translational rat model.
- There is increased accumulation of vancomycin in kidney tissue that
could account for the synergistic nephrotoxicity of the
vancomycin+flucloxacillin combination compared to vancomycin alone.
- Imipenem-cilastatin provided some protection against vancomycin
induced kidney injury.
Clinical significance
Antibiotic combinations can worsen or protect against vancomycin
induced kidney injury. Efforts should be made to advance kidney
protecting agents to clinical practice and to better understand the
compounded toxicity of co-nephrotoxins.