Comparison of acute kidney injury risk associated with vancomycin and concomitant piperacillin/tazobactam or cefepime in the intensive care unit
| Autor: | Drayton A. Hammond, Nicole C. Hartsock, Emir Kobic, Emily C. Richards, Mitchell S. Buckley, Andrew J. Berry, Laura M. Wicks, Dale Bikin, Melanie J. Yerondopoulos |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty medicine.medical_treatment Cefepime Critical Illness 030106 microbiology urologic and male genital diseases Critical Care and Intensive Care Medicine Tazobactam law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Sepsis medicine Humans 030212 general & internal medicine Renal replacement therapy Aged Retrospective Studies business.industry Incidence Acute Kidney Injury Middle Aged Intensive care unit female genital diseases and pregnancy complications Anti-Bacterial Agents Piperacillin Tazobactam Drug Combination Concomitant Piperacillin/tazobactam Vancomycin Female business medicine.drug Piperacillin |
| Zdroj: | Journal of critical care. 48 |
| ISSN: | 1557-8615 |
| Popis: | Purpose The objective of this study was to evaluate AKI incidence with concomitant vancomycin and piperacillin/tazobactam (PTZ) compared to vancomycin and cefepime (FEP) in critically ill patients. Materials and methods A retrospective, cohort study was conducted in adult critically ill patients from January 1, 2014 to December 31, 2017. The primary aim was to compare the incidence of AKI during concomitant therapy or until hospital discharge. Secondary analyses included AKI severity, time to AKI as well as recovery, and clinical outcomes. Results Overall, 333 patients were evaluated. The AKI rate in the vancomycin/PTZ group and vancomycin/FEP group were similar (19.5% vs. 17.3%, respectively, p = .612). Renal replacement therapy (RRT) was initiated in 10.0% and 3.8% administered vancomycin/PTZ and vancomycin/FEP groups, respectively (p = .04). Multivariate regression found vancomycin/PTZ was not associated with an increased risk of developing AKI although the presence of shock was identified as an independent risk factor (odds ratio, 3.22; 95% CI, 1.66–6.26). No significant differences in hospital or ICU length of stay or in-hospital mortality were observed between study groups. Conclusions Concomitant PTZ and vancomycin in ICU patients was not associated with an increased risk of developing AKI compared to FEP and vancomycin combinations. More patients administered vancomycin/PTZ received RRT. |
| Databáze: | OpenAIRE |
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