Assessment of nephrotoxicity risk and its predictors among vancomycin-treated patients admitted at Debre Markos comprehensive specialized hospital

Vancomycin is a commonly used antibiotic for the treatment of serious infections, but its use can potentially lead to kidney damage. This study aimed to evaluate the risks of nephrotoxicity among patients receiving vancomycin at Debre Markos Comprehensive Specialized Hospital. This prospective cohort study was conducted from April 1, 2024, to February 28, 2025, and involved 345 inpatients who were prescribed vancomycin. Demographic, clinical, and laboratory data were collected. Nephrotoxicity was defined as an increase in serum creatinine level of ≥ 0.5 mg/dL from baseline. Data analysis was conducted using SPSS software at a significance level of P < 0.05. The prevalence of vancomycin-associated acute nephrotoxicity was 25.2% in this study. Factors showing apparent associations with acute nephrotoxicity included lower educational status (individuals who never attended school (AOR = 9.86, p = 0.012 [CI: 1.67–58.16]) and those who can read and write (AOR = 11.49, p = 0.013 [CI: 1.69–78.07]), urinary tract infection (AOR = 15.5, p = 0.02 [CI: 1.49-161.02]), and concomitant use of omeprazole (AOR = 6.43, p = 0.002 [CI: 2.01–20.54]). Housewives, farmers, and individuals working private jobs showed a reduced risk with AORs of 0.11 ( p = 0.004 [0.03–0.50]), 0.04 ( p < 0.001 [0.007–0.18]), and 0.061 ( p = 0.004 [0.01–0.35]), respectively. This study highlights the importance of enhanced clinical awareness, particularly regarding the prescription of high-risk medications. Renal function screening should be a central component of the care of patients on vancomycin for vulnerable patient subgroups.