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. 1987 May;31(5):720–722. doi: 10.1128/aac.31.5.720

Effect of orally administered activated charcoal on vancomycin clearance.

R L Davis, R A Roon, J R Koup, A L Smith
PMCID: PMC174821  PMID: 3606073

Abstract

Vancomycin is a narrow-spectrum antibiotic that has concentration-dependent efficacy and toxicity. Recent literature indicates that orally administered activated charcoal can enhance the clearance of intravenously administered drugs. To evaluate the effects of activated charcoal on vancomycin clearance, six healthy male volunteers received vancomycin (1 g) intravenously with and without activated charcoal coadministration. In a randomized crossover sequence, subjects were given 50 g of activated charcoal immediately before the vancomycin infusion was begun and 15 g at 2, 4, 6, and 8 h afterwards, or an equal volume of water. Multiple doses of charcoal did not have a statistically significant effect on any pharmacokinetic parameter for vancomycin. Mean control values +/- standard deviation for vancomycin clearance, elimination half-life, and 24-h urinary recovery were 6.4 +/- 1.0 liters/h, 6.6 +/- 1.5 h, and 856 +/- 116 mg, respectively. Mean values for the same parameters were 6.4 +/- 1.0 liters/h, 6.0 +/- 0.9 h, and 897 +/- 130 mg when activated charcoal was given. We conclude that multiple doses of orally administered activated charcoal do not enhance vancomycin clearance in subjects with normal renal function when serum concentrations are within the therapeutic range. The results of this investigation cannot be extrapolated to patients with toxic vancomycin concentrations or renal dysfunction. The use of activated charcoal in these populations warrants further study.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berg M. J., Berlinger W. G., Goldberg M. J., Spector R., Johnson G. F. Acceleration of the body clearance of phenobarbital by oral activated charcoal. N Engl J Med. 1982 Sep 9;307(11):642–644. doi: 10.1056/NEJM198209093071102. [DOI] [PubMed] [Google Scholar]
  2. Berlinger W. G., Spector R., Goldberg M. J., Johnson G. F., Quee C. K., Berg M. J. Enhancement of theophylline clearance by oral activated charcoal. Clin Pharmacol Ther. 1983 Mar;33(3):351–354. doi: 10.1038/clpt.1983.44. [DOI] [PubMed] [Google Scholar]
  3. Blevins R. D., Halstenson C. E., Salem N. G., Matzke G. R. Pharmacokinetics of vancomycin in patients undergoing continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 1984 May;25(5):603–606. doi: 10.1128/aac.25.5.603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cook F. V., Farrar W. E., Jr Vancomycin revisited. Ann Intern Med. 1978 Jun;88(6):813–818. doi: 10.7326/0003-4819-88-6-813. [DOI] [PubMed] [Google Scholar]
  5. Cutler N. R., Narang P. K., Lesko L. J., Ninos M., Power M. Vancomycin disposition: the importance of age. Clin Pharmacol Ther. 1984 Dec;36(6):803–810. doi: 10.1038/clpt.1984.260. [DOI] [PubMed] [Google Scholar]
  6. GERACI J. E., HEILMAN F. R., NICHOLS D. R., ROSS G. T., WELLMAN W. E. Some laboratory and clinical experiences with a new antibiotic, vancomycin. Proc Staff Meet Mayo Clin. 1956 Oct 17;31(21):564–582. [PubMed] [Google Scholar]
  7. GERACI J. E., HEILMAN F. R., NICHOLS D. R., WELLMAN W. E. Antibiotic therapy of bacterial endocarditis. VII. Vancomycin for acute micrococcal endocarditis; preliminary report. Proc Staff Meet Mayo Clin. 1958 Apr 2;33(7):172–181. [PubMed] [Google Scholar]
  8. Gadgil S. D., Damle S. R., Advani S. H., Vaidya A. B. Effect of activated charcoal on the pharmacokinetics of high-dose methotrexate. Cancer Treat Rep. 1982 May;66(5):1169–1171. [PubMed] [Google Scholar]
  9. Golper T. A., Pulliam J., Bennett W. M. Removal of therapeutic drugs by continuous arteriovenous hemofiltration. Arch Intern Med. 1985 Sep;145(9):1651–1652. [PubMed] [Google Scholar]
  10. Hillman R. J., Prescott L. F. Treatment of salicylate poisoning with repeated oral charcoal. Br Med J (Clin Res Ed) 1985 Nov 23;291(6507):1472–1472. doi: 10.1136/bmj.291.6507.1472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. KIRBY W. M., DIVELBISS C. L. Vancomycin; clinical and laboratory studies. Antibiot Annu. 1956:107–117. [PubMed] [Google Scholar]
  12. Kärkkäinen S., Neuvonen P. J. Effect of oral charcoal and urine pH on dextropropoxyphene pharmacokinetics. Int J Clin Pharmacol Ther Toxicol. 1985 Apr;23(4):219–225. [PubMed] [Google Scholar]
  13. Levy G. Gastrointestinal clearance of drugs with activated charcoal. N Engl J Med. 1982 Sep 9;307(11):676–678. doi: 10.1056/NEJM198209093071109. [DOI] [PubMed] [Google Scholar]
  14. Matzke G. R., McGory R. W., Halstenson C. E., Keane W. F. Pharmacokinetics of vancomycin in patients with various degrees of renal function. Antimicrob Agents Chemother. 1984 Apr;25(4):433–437. doi: 10.1128/aac.25.4.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Matzke G. R., O'Connell M. B., Collins A. J., Keshaviah P. R. Disposition of vancomycin during hemofiltration. Clin Pharmacol Ther. 1986 Oct;40(4):425–430. doi: 10.1038/clpt.1986.201. [DOI] [PubMed] [Google Scholar]
  16. Moellering R. C., Jr, Krogstad D. J., Greenblatt D. J. Vancomycin therapy in patients with impaired renal function: a nomogram for dosage. Ann Intern Med. 1981 Mar;94(3):343–346. doi: 10.7326/0003-4819-94-3-343. [DOI] [PubMed] [Google Scholar]
  17. Neuvonen P. J., Elonen E. Effect of activated charcoal on absorption and elimination of phenobarbitone, carbamazepine and phenylbutazone in man. Eur J Clin Pharmacol. 1980 Jan;17(1):51–57. doi: 10.1007/BF00561677. [DOI] [PubMed] [Google Scholar]
  18. Park G. D., Goldberg M. J., Spector R., Johnson G. F., Feldman R. D., Quee C. K., Roberts P. The effects of activated charcoal on digoxin and digitoxin clearance. Drug Intell Clin Pharm. 1985 Dec;19(12):937–941. doi: 10.1177/106002808501901216. [DOI] [PubMed] [Google Scholar]
  19. Park G. D., Radomski L., Goldberg M. J., Spector R., Johnson G. F., Quee C. K. Effects of size and frequency of oral doses of charcoal on theophylline clearance. Clin Pharmacol Ther. 1983 Nov;34(5):663–666. doi: 10.1038/clpt.1983.229. [DOI] [PubMed] [Google Scholar]
  20. Park G. D., Spector R., Goldberg M. J., Johnson G. F. Expanded role of charcoal therapy in the poisoned and overdosed patient. Arch Intern Med. 1986 May;146(5):969–973. [PubMed] [Google Scholar]
  21. Radomski L., Park G. D., Goldberg M. J., Spector R., Johnson G. F., Quee C. K. Model for theophylline overdose treatment with oral activated charcoal. Clin Pharmacol Ther. 1984 Mar;35(3):402–408. doi: 10.1038/clpt.1984.50. [DOI] [PubMed] [Google Scholar]

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