Inage, Shunsuke, Nakamura, Shotaro, Isoe, Yuto, Okamoto, Saori, Uetake, Sho, Murakami, Misato, Yamaguchi, Ayaka, Morishima, Masayo, Nei, Takahito, Ise, Yuya, Katayama, Shiro, Shunsuke, Inage, Shotaro, Nakamura, Yuto, Isoe, Saori, Okamoto, Sho, Uetake, Misato, Murakami, Ayaka, Yamaguchi, Masayo, Morishima, Takahito, Nei, Yuya, Ise, and Shiro, Katayama
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.