Systematic Review and Metaanalysis of Acute Kidney Injury Associated With Concomitant Vancomycin and Piperacillin/Tazobactam

作者：Hammond Drayton A^*; Smith Melanie N; Li Chenghui; Hayes Sarah M; Lusardi Katherine; Bookstaver P Brandon

来源：Clinical Infectious Diseases, 2017, 64(5): 666-674.

DOI：10.1093/cid/ciw811

• acute kidney injury
• nephrotoxicity
• vancomycin
• piperacillin-tazobactam

Concomitant vancomycin and piperacillin/tazobactam (PT) may be associated with increased acute kidney injury (AKI) compared to vancomycin without PT. Medline, Cochrane, and Scopus were searched through October 2016 using "vancomycin," "piperacillin," " tazobactam," and "AKI," "acute renal failure," or "nephrotoxicity." A registered meta-analysis (PROSPERO: CRD42016041646) with relevant scenarios was performed. Fourteen observational studies totaling 3549 patients were analyzed. Concomitant vancomycin and PT was associated with AKI in unadjusted odds ratio (OR, 3.12; 95% confidence interval [CI], 2.04-4.78) and in adjusted OR (aOR, 3.11; 95% CI, 1.77-5.47) analyses. Similar findings were seen assessing studies in adults (aOR, 3.15; 95% CI, 1.72-5.76), children (OR, 4.55; 95% CI, 2.71-10.21), and when <50% of patients received care in an intensive care unit (aOR, 3.04; 95% CI, 1.49-6.22) but not >= 50% (aOR, 2.83; 95% CI, 0.74-10.85). Increased AKI with concomitant vancomycin and PT should be considered when determining beta-lactam therapy.

• 出版日期2017-3-1