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- Title
Vancomycin With Concomitant Piperacillin/Tazobactam vs. Cefepime or Meropenem Associated Acute Kidney Injury in General Ward Patients: A Multicenter Propensity Score-Matched Study.
- Authors
Komerdelj, Ivan A.; Buckley, Mitchell S.; D'Alessio, Paul A.; Ziadat, Delia S.; Kobic, Emir; Rangan, Pooja; Agarwal, Sumit K.; Tinta, Nicole C.; Yerondopoulos, Melanie J.; Kane-Gill, Sandra L.
- Abstract
Background: Concurrent administration of vancomycin and piperacillin/tazobactam (VAN+PTZ) may increase the risk of acute kidney injury (AKI) in hospitalized patients. Comprehensive characterization of VAN+PTZ associated AKI and recovery patterns remains lacking in previous reports. Objective: To compare the incidence of AKI associated with VAN+PTZ compared to either cefepime (CEF) or meropenem (MER) with VAN in adult general ward patients. Methods: A multicenter, retrospective, propensity score cohort study was conducted in non-critically ill adult patients. Included patients were concurrently administered VAN+PTZ or VAN+CEF/MER. Patients developing AKI ≤48 hours following combination therapy were excluded. The primary endpoint was to compare the incidence of AKI between study groups. Multivariable Cox regression modeling in predicting AKI was also conducted. Results: A total of 3199 patients met inclusion criteria and were evaluated. The incidence of AKI in VAN+PTZ and VAN+CEF/MER groups were 16.4% and 8.7%, respectively (P <.001). The onset to AKI was 1.8 days earlier with VAN+PTZ compared to VAN+CEF/MER (P <.001). Multivariable prediction model showed concomitant VAN+PTZ was identified as an independent risk factor of developing AKI (HR 2.34, 1.82-3.01, P <.001). The VAN+PTZ group experienced significantly higher rates of severe AKI (stage II or III) compared to the VAN+CEF/MER group (P =.002). No differences in the AKI recovery patterns were found between study groups. Conclusions: Concomitant VAN+PTZ in adult general ward patients was independently associated with an increased risk of AKI overall. More severe AKI was also associated with VAN+PTZ.
- Subjects
ANTIBIOTICS; MEROPENEM; RESEARCH; COMBINATION drug therapy; BETA lactam antibiotics; HOSPITAL patients; VANCOMYCIN; RETROSPECTIVE studies; DISEASE incidence; CEFEPIME; RISK assessment; COMPARATIVE studies; HOSPITAL wards; ROOMS; DESCRIPTIVE statistics; ACUTE kidney failure; LONGITUDINAL method; PROBABILITY theory
- Publication
Journal of Pharmacy Practice, 2024, Vol 37, Issue 1, p80
- ISSN
0897-1900
- Publication type
Article
- DOI
10.1177/08971900221125518