Prevention of Vancomycin-Induced Nephrotoxicity; An Updated Review of Clinical and Preclinical Studies

Purpose: This paper aims to review clinical and preclinical evidence regarding new strategies for the prevention of vancomycin-induced nephrotoxicity. Methods: Evidence from 2014 to the end of 2019 was included. Twelve animal studies and one clinical trial were evaluated. Results: Although the incidence of vancomycin-induced nephrotoxicity was not reduced significantly in the clinical trial, antioxidants reduced the incidence of vancomycin-induced nephrotoxicity in preclinical studies. Conclusion: Antioxidants including vitamin C, vitamin E, cilastatin, melatonin, zingerone, rutin, naringenin, saffron, silymarin, and dexmedetomidine were nephroprotective against vancomycininduced nephrotoxicity in preclinical studies. The nephroprotective effects of these antioxidants must be confirmed before routine use in clinical practice.