Friday October 10, 2008

Q; What is Hemodialysis induced Vancomycin rebound phenomenon?

A; There is a rebound in vancomycin plasma concentrations at the end of the session. The plasma profile of vancomycin concentrations versus time indicates that concentrations decrease dramatically during the session and then increase when the session is stopped. This rebound may result from drug recirculation from plasma protein binding sites.

Clinical Significance: This rebound may be clinically significant, and it must be taken into account when determining vancomycin trough levels. It is recommended that determination of vancomycin trough levels in patients undergoing chronic haemodialysis should be performed before the haemodialysis session.

Reference: click to get abstract

Clinical review: Use of vancomycin in haemodialysis patients Crit Care. 2002; 6(4): 313–316