Comparison of acute kidney injury risk associated with vancomycin and concomitant piperacillin/tazobactam or cefepime in the intensive care unit

Journal of Critical Care
Mitchell S BuckleyDrayton A Hammond

Abstract

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. 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. 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. Concomitant PTZ and vancomycin in ICU patients was not associated with an increased ri...Continue Reading

Citations

Jan 7, 2020·The Journal of Antimicrobial Chemotherapy·Frederico Carlos de Sousa Arnaud, Alexandre Braga Libório
Oct 16, 2019·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Shunsuke InageShiro Katayama
Sep 19, 2020·The Journal of Antimicrobial Chemotherapy·J D WorkumR J Brüggemann
Jun 5, 2019·Journal of Clinical Medicine·Ashley R Selby, Ronald G Hall
Jan 27, 2021·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Sarah R PiccuirroChristopher A Jankowski
Nov 5, 2020·Journal of the American College of Emergency Physicians Open·Andrea T CruzLuregn J Schlapbach
Dec 16, 2020·Antimicrobial Agents and Chemotherapy·Sean N AvedissianMarc H Scheetz
Mar 31, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·I BellosD N Perrea

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