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Acute Kidney Injury in Non-Intensive Care and Intensive Care Patients Treated with Vancomycin and Piperacillin-Tazobactam
1Section of Pharmaceutical Services, Nippon Medical School Hospital, Tokyo, Japan
2Department of Infection Control and Prevention, Nippon Medical School Hospital, Tokyo, Japan
Background: We investigated the incidence of acute kidney injury (AKI) and risk factors associated with vancomycin (VAN) and piperacillin-tazobactam (TZP) combination therapy in non-intensive care unit (ICU) and ICU settings.
Methods: In this single-center retrospective cohort study, adults who received VAN for ≥48 h during the period from 1 January 2016 through 31 December 2017 were included. The primary endpoint was incidence of AKI.
Results: Data from 593 adults were analyzed. The incidence of AKI was 10.6% overall, 8.0% in the non-TZP group, and 19.8% in the TZP group. In univariate analysis, the odds ratio (OR) for AKI was higher in the TZP group than in the non-TZP group (2.84, 95% CI = 1.64-4.90). In both the non-ICU and ICU settings, the OR for AKI was higher in the TZP group than in the non-TZP group (non-ICU: OR = 3.04, 95% CI = 1.52-6.09; ICU: OR = 2.51, 95% CI = 1.03-6.08). Furthermore, in propensity score analysis, the OR for AKI was higher in the TZP group than in the non-TZP group (OR = 2.81, 95% CI = 1.52-5.17). In both the non-ICU and ICU settings, the OR for AKI was higher in the TZP group than in the non-TZP group (non-ICU: OR = 2.57, 95% CI = 1.17-5.64; ICU: OR = 3.51, 95% CI = 1.05-11.6).
Conclusions: Combined use of TZP in patients receiving VAN increased AKI incidence in non-ICU and ICU settings.
J Nippon Med Sch 2020; 87: 66-72
Keywords
acute kidney injury, vancomycin, piperacillin-tazobactam, intensive care unit, nephrotoxicity
Correspondence to
Shunsuke Inage, Section of Pharmaceutical Services, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
shunsukeinage@nms.ac.jp
Received, March 23, 2019
Accepted, October 1, 2019
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