Acute kidney injury in non-intensive care unit and intensive care unit patients treated with vancomycin and piperacillin-tazobactam

Shunsuke Inage, Shotaro Nakamura, Yuto Isoe, Saori Okamoto, Sho Uetake, Misato Murakami, Ayaka Yamaguchi, Masayo Morishima, Takahito Nei, Yuya Ise, Shiro Katayama
2019 Journal of Nippon Medical School  
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. 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. Data from 593 adults were analyzed. The incidence of AKI was 10.6% overall, 8.0%
more » ... 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). Combined use of TZP in patients receiving VAN increased AKI incidence in non-ICU and ICU settings.
doi:10.1272/jnms.jnms.2020_87-203 pmid:31611508 fatcat:bx33qxrkbje35crfwacr3qphfm