Risk factors for acute kidney injury in vancomycin and piperacillin/tazobactam combination therapy: A retrospective study

J Infect Chemother. 2021 Nov;27(11):1614-1620. doi: 10.1016/j.jiac.2021.07.017. Epub 2021 Aug 6.

Abstract

Introduction: Combined 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.

Methods: The 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.

Results: In 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).

Conclusion: Our findings suggest that the concomitant use of vasopressors and initiating VPT combination therapy on the same day are likely risk factors for AKI development.

Keywords: Acute kidney injury; Combination therapy; Piperacillin/tazobactam; Vancomycin.

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / drug therapy
  • Acute Kidney Injury* / epidemiology
  • Anti-Bacterial Agents / adverse effects
  • Drug Therapy, Combination
  • Humans
  • Penicillanic Acid / adverse effects
  • Piperacillin / adverse effects
  • Piperacillin, Tazobactam Drug Combination / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Vancomycin* / adverse effects

Substances

  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination
  • Vancomycin
  • Penicillanic Acid
  • Piperacillin