Vancomycin combined with piperacillin/tazobactam increases the risk of acute kidney injury compared with vancomycin plus other anti-pseudomonal beta-lactams: a systematic review and network meta-analysis

被引：1

作者：

Pan, Kunming ^{[1
]}

Li, Ranyi ^{[1
]}

Li, Yanli ^{[1
]}

Ding, Xiaoqiang ^{[2
]}

Li, Xiaoyu ^{[1
]}

Lv, Qianzhou ^{[1
]}

机构：

[1] Fudan Univ, ZhongShan Hosp, Dept Pharm, 180 Fenglin Rd, Shanghai, Peoples R China

[2] Fudan Univ, ZhongShan Hosp, Dept Nephropathy, 180 Fenglin Rd, Shanghai, Peoples R China

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2024年 / 80卷 / 01期

基金：

中国国家自然科学基金;

关键词：

PATIENTS RECEIVING VANCOMYCIN; PROPENSITY SCORE METHODS; ACUTE-RENAL-FAILURE; CONCOMITANT VANCOMYCIN; INDUCED NEPHROTOXICITY; HOSPITALIZED-PATIENTS; COMBINATION THERAPY; ILL PATIENTS; TAZOBACTAM; CEFEPIME;

D O I：

10.1093/jac/dkae410

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objective: To explore whether vancomycin plus piperacillin/tazobactam actually increases nephrotoxicity compared with other anti-pseudomonal beta-lactams (BLs). Methods: PubMed, Embase, Web of Science, Cochrane, CNKI, Wanfang and VIP were searched from inception to October 2023. The primary outcomes were acute kidney injury (AKI) as defined as acute increase in serum creatinine of 0.3 mg/dL or 50% and severe Stage 2-3 AKI. Results: We included 70 studies (76 638 patients). Network meta-analysis indicated that vancomycin plus piperacillin/tazobactam was associated with significantly higher AKI risk than vancomycin plus cefepime (OR 2.55, 95% CI 2-3.28), vancomycin plus meropenem (OR 2.26, 95% CI 1.71-3.02) and vancomycin plus other uncommonly used BLs (OR 2.47, 95% CI 1.87-3.29). Also, vancomycin +piperacillin/tazobactam was associated with significantly higher Stage 2-3 AKI risk than vancomycin +cefepime (OR 2.22, 95% CI 1.34-3.62), vancomycin +meropenem (OR1.96, 95% CI 1.22-3.25) and vancomycin + uncommonly used BLs (OR 2.81, 95% CI 1.66- 4.91). Vancomycin plus piperacillin/tazobactam did not result in a significant difference in the incidence of receiving dialysis treatment, mortality, length of stay and time to AKI. Subgroup analyses of studies conducting propensity score matching demonstrated vancomycin +piperacillin/tazobactam was associated with significantly higher AKI rates than vancomycin +cefepime (OR 2.19, 95% CI 1.38-3.47) and vancomycin + meropenem (OR 1.38, 95% CI. 1.18-1.60). Subgroup analysis of critically ill patients and children indicated that vancomycin + piperacillin/tazobactam was associated with significantly higher AKI rates. Conclusions: Vancomycin +piperacillin/tazobactam significantly increased the risk of AKI and severe Stage 2-3 AKI compared with vancomycin plus other BLs. More prospective studies are needed.

引用

页码：47 / 58

页数：12

共 99 条

[11]

Bartlett Jenna W, 2020, J Pediatr Pharmacol Ther, V25, P521, DOI 10.5863/1551-6776-25.6.521

[12] Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group [J].

Bellomo, R ;

Ronco, C ;

Kellum, JA ;

Mehta, RL ;

Palevsky, P .

CRITICAL CARE, 2004, 8 (04) :R204-R212

[13] Acute kidney injury following the concurrent administration of antipseudomonal β-lactams and vancomycin: a network meta-analysis [J].

Bellos, I ;

Karageorgiou, V ;

Pergialiotis, V ;

Perrea, D. N. .

CLINICAL MICROBIOLOGY AND INFECTION, 2020, 26 (06) :696-705

[14]

Blevins AM, 2019, ANTIMICROB AGENTS CH, V63, DOI [10.1128/AAC.02658-18, 10.1128/aac.02658-18]

[15] Vancomycin with concomitant piperacillin/tazobactam vs. cefepime or meropenem associated acute kidney injury in the critically ill: A multicenter propensity score-matched study [J].

Buckley, Mitchell S. ;

Komerdelj, Ivan A. ;

D'Alessio, Paul A. ;

Rangan, Pooja ;

Agarwal, Sumit K. ;

Tinta, Nicole C. ;

Martinez, Brandon K. ;

Ziadat, Delia S. ;

Yerondopoulos, Melanie J. ;

Kobic, Emir ;

Kane-Gill, Sandra L. .

JOURNAL OF CRITICAL CARE, 2022, 67 :134-140

[16] Comparison of acute kidney injury risk associated with vancomycin and concomitant piperacillin/tazobactam or cefepime in the intensive care unit [J].

Buckley, Mitchell S. ;

Hartsock, Nicole C. ;

Berry, Andrew J. ;

Bikin, Dale S. ;

Richards, Emily C. ;

Yerondopoulos, Melanie J. ;

Kobic, Emir ;

Wicks, Laura M. ;

Hammond, Drayton A. .

JOURNAL OF CRITICAL CARE, 2018, 48 :32-38

[17] Comparison of the Incidence of Vancomycin-Induced Nephrotoxicity in Hospitalized Patients with and without Concomitant Piperacillin-Tazobactam [J].

Burgess, Lindsey D. ;

Drew, Richard H. .

PHARMACOTHERAPY, 2014, 34 (07) :670-676

[18]

Cannon John M, 2017, Spartan Med Res J, V2, P6440

[19] Comparative incidence and excess risk of acute kidney injury in hospitalised patients receiving vancomycin and piperacillin/tazobactam in combination or as monotherapy [J].

Carreno, Joseph ;

Smiraglia, Tori ;

Hunter, Christopher ;

Tobin, Ellis ;

Lomaestro, Ben .

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2018, 52 (05) :643-650

[20] Glomerular Function and Urinary Biomarker Changes between Vancomycin and Vancomycin plus Piperacillin-Tazobactam in a Translational Rat Model [J].

Chang, Jack ;

Pais, Gwendolyn M. ;

Valdez, Kimberly ;

Marianski, Sylwia ;

Barreto, Erin F. ;

Scheetz, Marc H. .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2022, 66 (03)

← 1 2 3 4 5 6 7 8 9 10 →