Minimal impact of low-density lipoprotein apheresis on vancomycin serum concentration: A case report

J Infect Chemother. 2024 Feb 4:S1341-321X(24)00029-1. doi: 10.1016/j.jiac.2024.01.018. Online ahead of print.

Abstract

Low-density lipoprotein apheresis (LDL-A) is a blood purification therapy used to treat refractory ulcers in patients with arteriosclerosis obliterans. We describe a case of vancomycin treatment in a patient undergoing maintenance hemodialysis and LDL-A therapy and assess its impact on serum vancomycin concentration. The patient underwent LDL-A twice a week (Mondays and Fridays) and maintenance dialysis three times a week (Tuesdays, Thursdays, and Saturdays) for diabetic nephropathy associated with type 1 diabetes mellitus. Following the wound culture results, vancomycin was initiated with a 1.75 g administration post-dialysis. Serum vancomycin levels before and after LDL-A, measured on the subsequent day, exhibited only slight fluctuations within the intermeasurement variability range. Despite continuing vancomycin administration at the standard dose in patients undergoing hemodialysis, the serum concentration remained consistent, suggesting a minimal impact of LDL-A on vancomycin pharmacokinetics.

Keywords: Low-density lipoprotein apheresis; Purification therapy; Serum concentration; Vancomycin.

Publication types

  • Case Reports