Vancomycin-Induced Acute Interstitial Nephritis

Risk Factors and Diagnosis

• Risk factors for acute tubulointerstitial nephritis include concomitant use of proton pump inhibitors (PPIs) and NSAIDs during antibiotic therapy, as recommended by the American Society of Clinical Oncology 1, 2
• Diagnosis of drug-induced AIN can be based on exclusion of other causes of acute kidney injury, according to the American Society of Clinical Oncology 2

Management

• Immediate discontinuation of the offending drugs (vancomycin and piperacillin-tazobactam) is the cornerstone of treatment, as recommended by the American Society of Clinical Oncology 2
• Methylprednisolone 1 mg/kg is recommended for moderate cases, and pulse methylprednisolone should be considered for stage 3 acute kidney injury, according to the American Society of Clinical Oncology 2