[Risk of Acute Kidney Injury in Patients Treated with Vancomycin and Piperacillin/Tazobactam Compared to Vancomycin and Meropenem or Doripenem: A Retrospective Cohort Study]
| Autor: | Naohito Ide, Kazuyo Sawaguchi, Seitaro Sato |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Risk medicine.medical_specialty Pharmaceutical Science 030226 pharmacology & pharmacy 01 natural sciences Meropenem Tazobactam Gastroenterology Cohort Studies 03 medical and health sciences 0302 clinical medicine Interquartile range Vancomycin Internal medicine Medicine Humans Aged Retrospective Studies Pharmacology Aged 80 and over 010405 organic chemistry business.industry Incidence Doripenem biochemical phenomena metabolism and nutrition Acute Kidney Injury Middle Aged 0104 chemical sciences Anti-Bacterial Agents Regimen Logistic Models Piperacillin Tazobactam Drug Combination Piperacillin/tazobactam Drug Therapy Combination Female business medicine.drug Piperacillin |
| Zdroj: | Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan. 139(12) |
| ISSN: | 1347-5231 |
| Popis: | It has been reported that the risk of acute kidney injury (AKI) is higher during treatment with vancomycin and piperacillin/tazobactam compared to use of vancomycin and cefepim or meropenem. We investigated the risk of AKI in patients receiving vancomycin and piperacillin/tazobactam versus those receiving vancomycin and meropenem or doripenem. The subjects were patients over 18 years old who received either vancomycin and piperacillin/tazobactam (V+P/T therapy) or vancomycin and carbapenems (meropenem or doripenem) (V+C therapy) for at least 48 h between 1 May 2013 and 28 February 2019. The primary endpoint was the incidence of AKI in patients receiving V+P/T or V+C therapy, while the secondary outcome was the timing of AKI in each group. The incidence of AKI was 33.3% (9/27) in patients receiving V+P/T therapy versus 9.1% (5/55) in those receiving V+C therapy, and its incidence was significantly higher with the former regimen (χ2=5.90, p=0.015). Multiple logistic regression analysis confirmed that V+P/T therapy was associated with an increased risk of AKI compared to V+C therapy (adjusted odds ratio: 5.05, 95% confidence interval: 1.46-17.5, p=0.01). The time to onset of AKI after initiation of treatment was not significantly different between patients receiving V+T/P or V+C therapy [median (interquartile range): 4 d (2-6 d) versus 7 d (3-10 d); p=0.282]. V+P/T therapy was associated with a significantly higher incidence of AKI than alternative regimens, suggesting that it should be avoided. When broad spectrum antibacterial therapy is required, V+C therapy should be considered instead. |
| Databáze: | OpenAIRE |
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