Piperacillin/tazobactam and risk of acute kidney injury in adults hospitalized with infection without vancomycin: a multi-centre real-world data analysis

医学 哌拉西林/他唑巴坦 万古霉素 他唑巴坦 急性肾损伤 内科学 哌拉西林 重症监护医学 遗传学 生物 细菌 铜绿假单胞菌 金黄色葡萄球菌
作者
Guobin Su,Cuixia Xiao,Yue Cao,Peiyan Gao,Di Xie,Qingqing Cai,Sheng Nie,Xusheng Liu,Fuhua Lu,Yilun Zhou,Ying Hu,Hua Li,Qiongqiong Yang,Qijun Wan,Bi‐Cheng Liu,Hong Xu,Guisen Li,Jianping Weng,Gang Xu,Chunbo Chen,Jialu Liu,Yongjun Shi,Yan Zha,Yaozhong Kong,Ying Tang,Jie Shen,David W. Johnson,Xin Xu,Fan Fan Hou
出处
期刊:International Journal of Antimicrobial Agents [Elsevier BV]
卷期号:61 (1): 106691-106691 被引量:11
标识
DOI:10.1016/j.ijantimicag.2022.106691
摘要

There is uncertainty about whether piperacillin/tazobactam (PT) increases the risk of acute kidney injury (AKI) in patients without concomitant use of vancomycin. This study compared the risk of hospital-acquired AKI (HA-AKI) among adults treated with PT or antipseudomonal β-lactams (meropenem, ceftazidime) without concomitant use of vancomycin.This real-world study analysed the data from China Renal Data System and assessed the risk of HA-AKI in adults hospitalized with infection after exposure to PT, meropenem or ceftazidime in the absence of concomitant vancomycin. The primary outcome was any stage of HA-AKI according to the Kidney Disease Improving Global Outcomes guidelines. A multi-variable Cox regression model and different propensity score (PS) matching models were used.Among the 29,441 adults [mean (standard deviation) age 62.44 (16.84) years; 17,980 females (61.1%)] included in this study, 14,721 (50%) used PT, 9081 (31%) used meropenem and 5639 (19%) used ceftazidime. During a median follow-up period of 8 days, 2601 (8.8%) develped HA-AKI. The use of PT was not associated with significantly higher risk of HA-AKI compared with meropenem [adjusted hazard ratio (aHR) 1.07, 95% confidence interval (CI) 0.97-1.19], ceftazidime (aHR 1.09, 95% CI 0.92-1.30) or both agents (aHR 1.07, 95% CI 0.97-1.17) after adjusting for confounders. Results were consistent in stratified analyses, PS matching using logistic regression or random forest methods to generate a PS, and in an analysis restricting outcomes to AKI stage 2-3.Without concomitant use of vancomycin, the risk of AKI following PT therapy is comparable with that of meropenem or ceftazidime among adults hospitalized with infection.
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