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Vancomycin With Concomitant Piperacillin/Tazobactam vs. Cefepime or Meropenem Associated Acute Kidney Injury in General Ward Patients: A Multicenter Propensity Score-Matched Study.
- Source :
-
Journal of Pharmacy Practice . Feb2024, Vol. 37 Issue 1, p80-87. 8p. - Publication Year :
- 2024
-
Abstract
- Background: Concurrent administration of vancomycin and piperacillin/tazobactam (VAN+PTZ) may increase the risk of acute kidney injury (AKI) in hospitalized patients. Comprehensive characterization of VAN+PTZ associated AKI and recovery patterns remains lacking in previous reports. Objective: To compare the incidence of AKI associated with VAN+PTZ compared to either cefepime (CEF) or meropenem (MER) with VAN in adult general ward patients. Methods: A multicenter, retrospective, propensity score cohort study was conducted in non-critically ill adult patients. Included patients were concurrently administered VAN+PTZ or VAN+CEF/MER. Patients developing AKI ≤48 hours following combination therapy were excluded. The primary endpoint was to compare the incidence of AKI between study groups. Multivariable Cox regression modeling in predicting AKI was also conducted. Results: A total of 3199 patients met inclusion criteria and were evaluated. The incidence of AKI in VAN+PTZ and VAN+CEF/MER groups were 16.4% and 8.7%, respectively (P <.001). The onset to AKI was 1.8 days earlier with VAN+PTZ compared to VAN+CEF/MER (P <.001). Multivariable prediction model showed concomitant VAN+PTZ was identified as an independent risk factor of developing AKI (HR 2.34, 1.82-3.01, P <.001). The VAN+PTZ group experienced significantly higher rates of severe AKI (stage II or III) compared to the VAN+CEF/MER group (P =.002). No differences in the AKI recovery patterns were found between study groups. Conclusions: Concomitant VAN+PTZ in adult general ward patients was independently associated with an increased risk of AKI overall. More severe AKI was also associated with VAN+PTZ. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANTIBIOTICS
*MEROPENEM
*RESEARCH
*COMBINATION drug therapy
*BETA lactam antibiotics
*HOSPITAL patients
*VANCOMYCIN
*RETROSPECTIVE studies
*DISEASE incidence
*CEFEPIME
*RISK assessment
*COMPARATIVE studies
*HOSPITAL wards
*ROOMS
*DESCRIPTIVE statistics
*ACUTE kidney failure
*LONGITUDINAL method
*PROBABILITY theory
Subjects
Details
- Language :
- English
- ISSN :
- 08971900
- Volume :
- 37
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Pharmacy Practice
- Publication Type :
- Academic Journal
- Accession number :
- 174943702
- Full Text :
- https://doi.org/10.1177/08971900221125518