Incidence of Acute Kidney Injury Among Critically Ill Patients With Brief Empiric Use of Antipseudomonal β-Lactams With Vancomycin

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Diana J SchreierErin F Barreto

Abstract

Nephrotoxins contribute to 20%-40% of acute kidney injury (AKI) cases in the intensive care unit (ICU). The combination of piperacillin-tazobactam (PTZ) and vancomycin (VAN) has been identified as nephrotoxic, but existing studies focus on extended durations of therapy rather than the brief empiric courses often used in the ICU. The current study was performed to compare the risk of AKI with a short course of PTZ/VAN to with the risk associated with other antipseudomonal β-lactam/VAN combinations. The study included a retrospective cohort of 3299 ICU patients who received ≥24 but ≤72 hours of an antipseudomonal β-lactam/VAN combination: PTZ/VAN, cefepime (CEF)/VAN, or meropenem (MER)/VAN. The risk of developing stage 2 or 3 AKI was compared between antibiotic groups with multivariable logistic regression adjusted for relevant confounders. We also compared the risk of persistent kidney dysfunction, dialysis dependence, or death at 60 days between groups. The overall incidence of stage 2 or 3 AKI was 9%. Brief exposure to PTZ/VAN did not confer a greater risk of stage 2 or 3 AKI after adjustment for relevant confounders (adjusted odds ratio [95% confidence interval] for PTZ/VAN vs CEF/VAN, 1.11 [.85-1.45]; PTZ/VAN vs MER/VAN, 1.0...Continue Reading

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Citations

Jan 7, 2020·The Journal of Antimicrobial Chemotherapy·Frederico Carlos de Sousa Arnaud, Alexandre Braga Libório
Dec 14, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sean N AvedissianMarc H Scheetz
Jul 13, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Diana J SchreierErin F Barreto
Sep 19, 2020·The Journal of Antimicrobial Chemotherapy·J D WorkumR J Brüggemann
Jul 13, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Marin H KollefScott T Micek
Jun 5, 2019·Journal of Clinical Medicine·Ashley R Selby, Ronald G Hall
Sep 11, 2019·Journal of the American Society of Nephrology : JASN·Emily L JoyceJohn A Kellum
Jan 1, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jazmin D LeeBrian C Lund
Mar 31, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·I BellosD N Perrea
Aug 10, 2021·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Yuma YamashitaHiroshi Kakeya

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