Vascular complications of intravenous vancomycin: Safety of peripheral, midline and central catheters. A scoping review

Introduction Vancomycin treats severe infections by resistant bacteria, but its acidity and local toxicity demand careful intravenous administration. Central venous catheters reduce these risks but pose complications. Midline catheters offer a less invasive alternative, though evidence remains limited.Objectives To map and describe the available clinical evidence on the safety and vascular complications associated with peripheral intravenous administration of vancomycin, compared with other vascular access devices, focusing on the type of complications reported, their diagnostic methods, and the methodological characteristics of the studies.Method A scoping review was conducted following the PRISMA-ScR guidelines. A comprehensive literature search was performed in Medline (via PubMed), Web of Science, Cochrane Library, CINAHL, and CUIDEN databases to identify studies reporting on intravenous vancomycin administration, catheter type and associated complications.Results Four studies met the inclusion criteria-two clinical trials and two cohort studies-with sample sizes ranging from 14 to 1087 participants. All studies reported complications attributed to vancomycin, regardless of catheter type. Two studies reported low rates of certain complications in patients receiving vancomycin through midline catheters, while other studies described complications associated with peripheral administration or recommended central access based on clinical considerations.Conclusion The available studies report heterogeneous findings regarding vascular complications associated with different vascular access devices for vancomycin administration. The evidence is limited and methodologically diverse, highlighting important gaps in the literature regarding outcome definitions, diagnostic approaches, and comparative evaluation across catheter types.