Concomitant vancomycin and piperacillin/tazobactam treatment is associated with an increased risk of acute kidney injury in Japanese patients |
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| Institution: | 1. Department of Pharmacy, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama, 708-0841, Japan;2. Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;1. Laboratory of Infectious Diseases, Graduate School of Infection Control Sciences & Kitasato Institute for Life Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan;2. Division of Clinical Laboratory, Sanritsu Zelkova Veterinary Laboratory, 3-5-5 Ogibashi, Koto-ku, Tokyo, 135-0011, Japan;1. Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;2. Division of Environmental and Preventive Medicine, Department of Social Medicine, Graduate School of Medicine, Tottori University, Tottori, Japan;3. Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan;4. Osaka City Public Health Office, Osaka, Japan;5. Antimicrobial Resistance Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan;1. Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China;2. Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China;1. Department of Internal Medicine, Fukuwatari Municipal Hospital, Okayama, Japan;3. Department of Internal Medicine, Nippon Kokan Fukuyama Hospital, Fukuyama, Japan;4. Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan;6. Department of Surgery, Nippon Kokan Fukuyama Hospital, Fukuyama, Japan;5. Department of Bacteriology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan;1. Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;2. Nagasaki University Infection Control and Education Centre, Nagasaki University Hospital, Nagasaki, Japan;1. Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan;2. Kitakyushu City Public Health and Welfare Bureau, 1-1 Jonai, Kokurakita-ku, Kitakyushu, Fukuoka, 803-8501, Japan;3. Kitakyushu City Institute of Health and Environmental Sciences, 1-2-1 Shinike, Tohata-ku, Kitakyushu, Fukuoka, 804-0092, Japan;4. Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan;5. Toyama Institute of Health, 17-1 Nakataikouyama, Imizu, Toyama, 939-0363, Japan |
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| Abstract: | IntroductionRecent studies have corroborated that the co-administration of vancomycin (VCM) and piperacillin/tazobactam (PT) is correlated with an increased incidence of acute kidney injury (AKI). However, evidence directed at the Japanese population is scarce. Therefore, we conducted a retrospective study to compare the occurrence of AKI among Japanese patients who received VCM with PT (VP therapy) and VCM with another β-lactams (VA therapy).MethodsThe present study, performed at Tsuyama Chuo Hospital between June 2012 and December 2018, included adult patients who received VCM and β-lactam antibiotics for ≥48 h. We defined the primary outcome as the incidence of AKI based on the risk, injury, failure, loss, and end-stage kidney disease criteria. Patients' clinical characteristics and outcomes were reviewed and compared between the two groups with univariate and multivariate logistic regression analyses. Subgroup analysis was conducted by stratifying the patients’ baseline hospital admittance status, as intensive care unit or general wards.ResultsWe analyzed 272 patients (92 V P therapy and 180 VA therapy). Univariate analysis revealed a significant difference in AKI development between VP and VA therapy (25.0% vs 12.2%; p < 0.01). A multivariate analysis demonstrated that VP therapy and VCM initial trough levels ≥15 μg/mL were associated with an incidence of AKI. Patients at general wards, rather than those admitted at an intensive care unit, developed AKI with VP therapy (p = 0.02).ConclusionVP therapy was associated with an increased risk of AKI compared to that with VA therapy among the Japanese population. |
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| Keywords: | Acute kidney injury β-lactams Piperacillin/tazobactam Vancomycin |
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