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Antimicrob Agents Chemother. 1987 October; 31(10): 1461-1464

Alanine aminopeptidase and beta 2-microglobulin excretion in patients receiving vancomycin and gentamicin.

M J Rybak, J J Frankowski, D J Edwards and L M Albrecht

Department of Pharmacy Practice, Wayne State University College of Pharmacy, Detroit, Michigan.

ABSTRACT

The effects of vancomycin, gentamicin, and combination vancomycin-gentamicin treatments on alanine aminopeptidase (AAP) and beta 2-microglobulin (beta 2M) elimination in 30 hospitalized patients were assessed and compared with elimination in a control group. Twenty-four-hour urine excretion values for AAP and beta 2M were determined on treatment day 1 and day 5 for patients receiving the three treatment regimens and for the control group. AAP excretion values for the vancomycin-treated group were not found to be statistically different from those of the control group. Both the gentamicin and the vancomycin-gentamicin groups had statistically higher AAP excretion values on treatment day 1 as well as on treatment day 5 when compared with the vancomycin and control groups. AAP excretion on day 5 of treatment was highest for the vancomycin-gentamicin group. Overall, beta 2M elimination was variable in all treatment groups. Although the beta 2M values were elevated as early as day 1 in all treatment groups, they were significantly elevated only in the vancomycin-gentamicin group on day 1 and only in the gentamicin group on day 5 compared with the vancomycin and the control groups. AAP appears to be a sensitive indicator of renal tubular damage. The combination of vancomycin and gentamicin results in greater AAP excretion than does either agent alone.

Antimicrob Agents Chemother. 1987 October; 31(10): 1461-1464




This article has been cited by other articles:

  • Rybak, M., Lomaestro, B., Rotschafer, J. C., Moellering, R. Jr., Craig, W., Billeter, M., Dalovisio, J. R., Levine, D. P. (2009). Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm 66: 82-98 [Full Text]  
  • Edwards, D. J. (1991). Therapeutic Drug Monitoring of Aminoglycosides and Vancomycin: Guidelines and Controversies. Journal of Pharmacy Practice 4: 211-224  


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