Risk factors for acute kidney injury in vancomycin and piperacillin/tazobactam combination therapy: A retrospective study. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Yamashita, Yuma; Kawaguchi, Hiroshi; Yano, Tsubasa; Sakurai, Norihiro; Shibata, Wataru; Oshima, Kazuhiro; Imai, Takumi; Yamada, Koichi; Nakamura, Yasutaka; Nagayama, Katsuya; Kakeya, Hiroshi
• Is Part Of: Journal of infection and chemotherapy. Volume 27:Issue 11(2021)
• Page Start: 1614
• Page End: 1620
• Publication Date: 2021-11
• Subjects: Acute kidney injury -- Vancomycin -- Piperacillin/tazobactam -- Combination therapy; VCM vancomycin -- PIPC/TAZ piperacillin/tazobactam -- AKI acute kidney injury -- VPT VCM and PIPC/TAZ -- MRSA methicillin-resistant Staphylococcus aureus -- FN febrile neutropenia -- KDIGO Kidney Disease Improving Global Outcomes -- Scr serum creatinine -- CrCL creatinine clearance -- ICU intensive care unit -- Sepsis-3 the third international consensus definitions for sepsis and septic shock -- NSAIDs non-steroidal anti-inflammatory drugs -- ACEI angiotensin-converting enzyme inhibitor -- ARB angiotensin II receptor blocker -- IQR interquartile range -- TIMP-2 urinary tissue inhibitor of metalloproteinase-2 -- IGFBP7 insulin-like growth factor binding-protein 7 -- AUC area under the blood concentration-time curve; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2021.07.017
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Introduction: Combined use of vancomycin (VCM) and piperacillin/tazobactam (PIPC/TAZ) has been reported to increase the incidence of acute kidney injury (AKI). However, the risk factors associated with AKI after VCM and PIPC/TAZ (VPT) administration have not yet been identified. Therefore, we retrospectively assessed patients treated with VPT to investigate the risk factors for AKI development. Methods: The study involved patients who were treated with VPT from January 1, 2016 to March 31, 2020. The patients were divided into the AKI or non-AKI group. The clinical characteristics of patients and antimicrobial therapy were compared between the groups. Their association with AKI risk was evaluated using multivariate logistic regression analysis. Results: In total, 182 patients were included, with 118 in the non-AKI group and 64 in the AKI group. Therefore, the incidence of AKI was 35.2 %. The initiation of VPT combination therapy on the same day and concomitant use of vasopressors were associated with an increased risk of AKI (odds ratio [OR] 2.55, 95 % confidential interval [CI] 1.20–5.44 and OR 3.22, 95 % CI 1.31–7.89, respectively). Conclusion: Our findings suggest that the concomitant use of vasopressors and initiating VPT combination therapy on the same day are likely risk factors for AKI development.