Vancomycin-associated nephrotoxicity: A meta-analysis of administration by continuous versus intermittent infusion

Timothy Hanrahan, Tony Whitehouse, Jeffrey Lipman, Jason A Roberts

Research output: Contribution to journalReview articlepeer-review


Vancomycin is a glycopeptide antibiotic widely used in the management of meticillin-resistant Staphylococcus aureus (MRSA). Guidelines currently recommend vancomycin be administered by intermittent infusion, despite recent research suggesting that continuous infusion (CI) may be associated with lower rates of vancomycin-associated nephrotoxicity. In 2012, Cataldo et al. presented a meta-analysis supporting the use of CI. Here we present an updated meta-analysis, inclusive of a recently published large-scale retrospective study. PubMed, EMBASE and Cochrane Reviews databases were searched using the keywords 'vancomycin' and 'continuous' or 'intermittent' or 'infusion' or 'discontinuous' or 'administration'. Seven studies were included in the final analysis. Using a random-effects model, a non-significant trend of reduced nephrotoxicity in those who received vancomycin by CI (risk ratio=0.799, 95% confidence interval 0.523-1.220; P=0.299) was identified. A large, randomised controlled trial is necessary to confirm these results.

Original languageEnglish
Pages (from-to)249-53
Number of pages5
JournalInternational Journal of Antimicrobial Agents
Issue number3
Publication statusPublished - Sept 2015

Bibliographical note

Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.


  • Acute Kidney Injury/chemically induced
  • Anti-Bacterial Agents/administration & dosage
  • Humans
  • Infusions, Intravenous/methods
  • Methicillin-Resistant Staphylococcus aureus/drug effects
  • Retrospective Studies
  • Staphylococcal Infections/drug therapy
  • Vancomycin/administration & dosage


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