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Systematic Review and Meta-Analysis of Acute Kidney Injury Associated With Concomitant Vancomycin and Piperacillin/tazobactam

Systematic Review and Meta-Analysis of Acute Kidney Injury Associated With Concomitant Vancomycin and Piperacillin/tazobactam

Drayton A Hammond, Melanie N Smith, Chenghui Li, Sarah M Hayes, Katherine Lusardi, P Brandon Bookstaver

Clin Infect Dis. 2017 Mar 1;64(5):666-674.

PMID: 27940946

Abstract:

Concomitant vancomycin and piperacillin/tazobactam may be associated with increased acute kidney injury (AKI) compared to vancomycin without piperacillin/tazobactam. A systematic search of Medline, Cochrane Library, and Scopus through October 2016 using ["vancomycin" and "piperacillin" and "tazobactam"] and ["AKI" or "acute renal failure" or "nephrotoxicity"] and registered meta-analysis (PROSPERO: CRD42016041646) with relevant scenarios was performed. From 307 results, fourteen observational studies totaling 3549 patients were analyzed. Concomitant vancomycin and piperacillin/tazobactam was associated with AKI in unadjusted (odds ratio (OR) 3.12, 95% confidence interval (CI) 2.04-4.78) and adjusted (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 piperacillin/tazobactam should be considered when determining beta-lactam therapy.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP66258762	Piperacillin		66258-76-2	Price

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