Risk factors for acute kidney injury in vancomycin and piperacillin/tazobactam combination therapy: A retrospective study |
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| Affiliation: | 1. Department of Pharmacy, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan;2. Department of Infection Control Science, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan;3. Department of Quality and Safety Management, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan;4. Department of Medical Statistics, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan;1. Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan;2. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA;3. Department of Pediatrics, UCLA Mattel Children''s Hospital, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA;4. Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children''s Medical Center, Tokyo, Japan;5. Department of Infectious Diseases, National Center for Global Health and Medicine, Tokyo, Japan;6. Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan;7. Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, USA;1. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan;2. Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan;3. Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan;1. Department of Clinical Pharmacology, College of Pharmacy, Dalian Medical University, China;2. Provincial Key Laboratory for Pharmacokinetics and Transport, Liaoning, Dalian Medical University, China;3. Department of Clinical Pharmacy, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China;1. Department of Clinical Laboratory, Naga Municipal Hospital, Wakayama, Japan;2. Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan;3. Department of Medical Life Science, Kurashiki University of Science and the Arts, Okayama, Japan;4. Department of Medical Technology and Sciences Facility of Health Sciences, Kyoto Tachibana University, Kyoto, Japan;5. Department of Clinical Laboratory, Shiga Medical Center for Children, Shiga, Japan;6. Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan;7. Department of Infection Control and Prevention, Osaka City University Hospital, Osaka, Japan;8. Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan;9. Department of Clinical Laboratory, Osaka Police Hospital, Osaka, Japan;1. Department of Pharmacy Services, University of Florida Health Shands Hospital, Gainesville, FL;2. Department of Pharmacy Services, University of Florida Health Shands Cancer Hospital, Gainesville, FL;3. Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL |
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| Abstract: | IntroductionCombined use of vancomycin (VCM) and piperacillin/tazobactam (PIPC/TAZ) has been reported to increase the incidence of acute kidney injury (AKI). However, the risk factors associated with AKI after VCM and PIPC/TAZ (VPT) administration have not yet been identified. Therefore, we retrospectively assessed patients treated with VPT to investigate the risk factors for AKI development.MethodsThe study involved patients who were treated with VPT from January 1, 2016 to March 31, 2020. The patients were divided into the AKI or non-AKI group. The clinical characteristics of patients and antimicrobial therapy were compared between the groups. Their association with AKI risk was evaluated using multivariate logistic regression analysis.ResultsIn total, 182 patients were included, with 118 in the non-AKI group and 64 in the AKI group. Therefore, the incidence of AKI was 35.2 %. The initiation of VPT combination therapy on the same day and concomitant use of vasopressors were associated with an increased risk of AKI (odds ratio [OR] 2.55, 95 % confidential interval [CI] 1.20–5.44 and OR 3.22, 95 % CI 1.31–7.89, respectively).ConclusionOur findings suggest that the concomitant use of vasopressors and initiating VPT combination therapy on the same day are likely risk factors for AKI development. |
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