Vancomycin

Author Information

An event is serious (based on the ICH definition) when the patient outcome is:

• * death

• * life-threatening

• * hospitalisation

• * disability

• * congenital anomaly

• * other medically important event

A 36-year-old man developed acute renal failure during treatment with vancomycin for Streptococcus pneumoniae pneumonia and meningitis.

The man was hospitalised on 20 October 2020 due to vancomycin sensitive Streptococcus pneumoniae pneumonia and meningitis. He required mechanical ventilation for 5 days due to the severe respiratory failure. He received vancomycin [route and dosage not stated], which led to acute renal failure [duration of treatment to reaction onset not stated].

The man underwent 2 haemodialysis sessions. Vancomycin was replaced with meropenem and ceftriaxone. Consequently, his renal function recovered. He was transferred to the another tertiary centre on 30 October 2020. On 1 November 2020, he developed cardiorespiratory arrest due to massive pleural effusions and decompensated heart failure, which were conservatively treated. He was mechanically ventilated and weaned off respirator. Antibiotic therapy with flucloxacillin was continued. On 28 November 2020, he was moved to the infectology clinic due to positive COVID swab. Subsequently, he developed bilateral COVID-19 pneumonia, and he received treatment with remdesivir and off label dexamethasone. He was then moved to the designated COVID-19 hospital on 16 December 2020. He was found to have severe infective endocarditis and a large abscess of the aortic root. On 17 December 2020, he underwent a cardiac surgery. The postoperative recovery was uneventful, and he was discharged on 29 December 2020.