Acute kidney injury with combination vancomycin and piperacillin-tazobactam therapy in the ICU: A retrospective cohort study

O’Callaghan, Kevin; Hay, Karen; McNamara, John F.

doi:10.1016/j.ijantimicag.2020.106010

Cited by 14 publications

(15 citation statements)

References 18 publications

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“…Several studies have reported risk factors for vancomycin‐associated AKI 6–12 . The reported risk factors are diverse, including patient factors (e.g., sex, body weight and race), drug‐related factors (e.g., dose and duration of vancomycin) and concomitant drug factors (e.g., use of aminoglycosides, piperacillin–tazobactam, antiviral agents and nonsteroidal anti‐inflammatory drugs).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for vancomycin‐associated acute kidney injury: A systematic review and meta‐analysis

Kim

Yee

Yoon

et al. 2022

Brit J Clinical Pharma

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and obesity (OR 1.46, 95% CI: 1.12-1.90) were associated with an increase in vancomycin-associated AKIs. In terms of vancomycin-related factors, longer treatment duration (>14 d; OR 1.73, 95% CI: 1.06-2.83), serum vancomycin trough level >15 μg/mL (OR 2.10, 95% CI: 1.43-3.07) and vancomycin trough level >20 μg/mL (OR 2.84, 95% CI: 1.48-5.44) increased the risks of vancomycin-associated AKI. For comorbidities and clinical factors, renal disease (OR 2.19, 95% CI: 1.51-3.17) showed the highest odds of vancomycin-associated AKI, followed by hepatic disease, intensive care unit admission, heart failure, sepsis, coronary heart disease and diabetes mellitus. For concomitant nephrotoxic drugs, amphotericin B (OR 5.21, 95% CI: 3.44-7.87) showed the highest odds of vancomycin-associated AKI, followed by acyclovir (OR 3.22, 95% CI: 1.39-7.46), vasopressors, loop diuretics, piperacillintazobactam and aminoglycoside. The use of any concomitant nephrotoxic agent (OR 1.74, 95% CI: 1.17-2.58) increased the odds of vancomycin-associated AKI. Conclusion:Our results may help predict the risk of vancomycin-associated AKI in the clinical setting. K E Y W O R D S acute kidney injury, meta-analysis, risk factors, systematic review, vancomycin 1 | INTRODUCTION Vancomycin is a glycopeptide antibiotic agent used to treat severe infections, such as sepsis, osteomyelitis or pneumonia caused by methicillin-resistant Staphylococcus aureus. 1 Acute kidney injury (AKI) is a well-known adverse drug reaction of vancomycin. Estimates of the incidence of vancomycin-associated AKI vary from 5 to 43%. 2Since AKI has a significant impact on clinical outcomes, such as length of hospital stay or overall mortality, it is crucial to decrease the AKI incidence in hospitals. [3][4][5] Several studies have reported risk factors for vancomycinassociated AKI. [6][7][8][9][10][11][12] The reported risk factors are diverse, including patient factors (e.g., sex, body weight and race), drug-related factors (e.g., dose and duration of vancomycin) and concomitant drug factors

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Section: Introductionmentioning

confidence: 99%

Risk factors for vancomycin‐associated acute kidney injury: A systematic review and meta‐analysis

Kim

Yee

Yoon

et al. 2022

Brit J Clinical Pharma

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“…In line with these results, Kang et al revealed an increased risk of AKI in the TZP–VAN group in comparison with the FEP–VAN group (52.7% vs. 27.7%, p < 0.001) in 340 ICU patients [ 34 ]. In other studies (n = 6), although the incidences of AKI were higher in the TZP–VAN patients than in the comparison groups numerically, these differences were not able to attain statistical significance [ 20 , 30 , 32 , 35 , 37 , 41 ]. Similarly, in a meta-analysis, Hammond et al showed that a higher risk of AKI was not observed in the TZP–VAN group when the studies with ≥50% of patients receiving antibiotic therapy in ICUs were included in the analysis alone (in adjusted analysis OR, 2.83; 95% CI, 0.74–10.85) [ 13 ].…”

Section: Epidemiology Of Tzp Plus Van-associated Aki In Icu Patientsmentioning

confidence: 79%

“…It should be noted that these studies minimize the confounding by indication that is typical when the comparator group comprises patients receiving VAN monotherapy. The results of the studies are summarized in Table 1 [ 9 , 10 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. According to these studies, patients treated to the TZP–VAN combination regimen are 1.2–9.5 times more likely to develop AKI compared to those receiving FEP–VAN or MER–VAN combinations.…”

Section: Epidemiology Of Tzp Plus Van-associated Akimentioning

confidence: 99%

Piperacillin–Tazobactam Plus Vancomycin-Associated Acute Kidney Injury in Adults: Can Teicoplanin or Other Antipseudomonal Beta-Lactams Be Remedies?

Aslan

Akova

2022

Healthcare

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Numerous observational studies and meta-analyses have suggested that combination therapy consisting of piperacillin–tazobactam (TZP) and vancomycin (VAN) augments acute kidney injury (AKI) risk when compared to viable alternatives, such as cefepime–vancomycin (FEP–VAN) and meropenem–VAN. However, the exact pathophysiological mechanisms of this phenomenon are still unclear. One major limitation of the existing studies is the utilization of serum creatinine to quantify AKI since serum creatinine is not a sufficiently sensitive and specific biomarker to truly define the causal relationship between TZP–VAN exposure and nephrotoxicity. Even so, some preventive measures can be taken to reduce the risk of AKI when TZP–VAN is preferred. These measures include limiting the administration of TZP–VAN to 72 h, choosing FEP–VAN in place of TZP–VAN in appropriate cases, monitoring the VAN area under the curve level rather than the VAN trough level, avoiding exposure to other nephrotoxic agents, and minimizing the prescription of TZP–VAN for patients with a high risk of AKI. More data are needed to comment on the beneficial impact of the extended-infusion regimen of TZP on nephrotoxicity. Additionally, TZP and teicoplanin can be reasonable alternatives to TZP–VAN for the purpose of lowering AKI risk. However, the data are scarce to advocate this practice convincingly.

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“…The use of iodine-based contrast media can also lead to acute kidney injury during hospitalization and eventually to persistent renal insufficiency or end-stage renal disease ( Cheng et al, 2020 ; Weisbord et al, 2020 ). In addition, prolonged antibiotic therapy with vancomycin also greatly increases the risk of acute kidney injury ( O'Callaghan et al, 2020 ). Immune-related adverse events caused by immune checkpoint inhibitors when used in cancer treatment can affect the kidneys, leading to acute kidney injury associated with immune checkpoint inhibitor therapy ( Meraz-Muñoz et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Drug-induced kidney injury in Chinese critically ill pediatric patients

et al. 2022

Front. Pharmacol.

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Background: Drug-induced acute kidney injury (DIKI) is a common adverse drug reaction event but is less known in pediatric patients. The study explored the DIKI in Chinese pediatric patients using the Pediatric Intensive Care database (PIC).Method: We screened pediatric patients with acute kidney injury (AKI) using the KDIGO criteria from the PIC and then assessed the relationship between their drugs and DIKI using the Naranjo scale. For the fifteen frequently used DIKI-suspected drugs, we divided patients into drug-exposed and non-exposed groups, using the outcome of whether DIKI was presented or not. Propensity score matching (PSM) was used to control for the effects of four confounders, age, gender, length of hospital stay, and major diagnosis. Unconditional logistic regression was used to identify statistically significant differences between the two groups.Results: A total of 238 drugs were used 1,863 times by the 81 patients with DIKI during their hospital stay. After screening the Naranjo scale to identify the top 15 suspected DIKI drugs with a high frequency of use, we found that furosemide injection (p = 0.001), midazolam injection (p = 0.001), 20% albumin prepared from human plasma injection (p = 0.004), fentanyl citrate injection (p = 0.001), compound glycyrrhizin injection (p = 0.026), vancomycin hydrochloride for intravenous (p = 0.010), and milrinone lactate injection (p = 0.009) were associated with DIKI.Conclusion: In critically ill pediatric patients, DIKI is more likely to occur after using furosemide injection, midazolam injection, 20% albumin prepared from human plasma injection, fentanyl citrate injection, compound glycyrrhizin injection, vancomycin hydrochloride for intravenous, milrinone lactate injection.

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Acute kidney injury with combination vancomycin and piperacillin-tazobactam therapy in the ICU: A retrospective cohort study

Cited by 14 publications

References 18 publications

Risk factors for vancomycin‐associated acute kidney injury: A systematic review and meta‐analysis

Risk factors for vancomycin‐associated acute kidney injury: A systematic review and meta‐analysis

Piperacillin–Tazobactam Plus Vancomycin-Associated Acute Kidney Injury in Adults: Can Teicoplanin or Other Antipseudomonal Beta-Lactams Be Remedies?

Drug-induced kidney injury in Chinese critically ill pediatric patients

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