Evaluation of chemoprotective effect of NAC on vancomycin induced nephrotoxicity in acute bacterial meningitis patients

the main goal of this study is evaluation of chemoprotective effect of NAC on vancomycin induced nephrotoxicity in acute bacterial meningitis patients and its specific goal is evaluating saftey and efficacy of NAC on vancomycin induced nephrotoxicity. Inclusion criteria: Filling consent form Patients with diagnosis of acute bacterial meningitis who are candidated for receiving vancomycin Age≥16 yrs Not receive vancomycin in last 2weeks Exclusion criteria: Clinical states which could change phahrmacokinetic of vancomycin (eg. burn, cystic fibrosis) Pregnancy Patients with CKD who need dialysis Contraindication for vancomycin, treatment with other nephrotoxic agents. this study is a randomized controlled clinical trial which 60 patients with diagnosis of acute bacterial meningitis who have indication for recieving vancomycin included in it. They will be devided in two 30patients group, that first group will receive vancomycin with NAC(1200mg BD) and second group will receive vancomyc in 1hour infusion. all patients will be evaluated during the study for clinical response on basis of laboratory parameters (CBC & LP findings), physiologic examination at the begining of study and 5 and 10 days of treatment,10cc blood sample will be drawn from all of the patients for evaluating the level of Cystatin-C. after infusion of third dose of vancomycin and in 10th day of therapy before morning dose ,blood sample for measurement of serum trough level of vancomycin will be drawn. Serum creatinine will be checked every other days. serum level of acute kidney injury biomarker and vancomycin will be measured with standard methods.

Shahid Beheshti University of Medical Science (pharmacy faculty)