King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; The University of Arizona, College of Pharmacy, Tucson, USA.
J Infect Public Health. 2017 Nov-Dec;10(6):770-773. doi: 10.1016/j.jiph.2016.11.007. Epub 2017 Feb 13.
The purpose of this study was to evaluate the observed incidence of acute kidney injury (AKI) in adult patients receiving either piperacillin-tazobactam (PT) and vancomycin or meropenem and vancomycin for at least 48h. In this retrospective cohort study, we included adult patients with no known renal dysfunction who received either the combination of PT-vancomycin or meropenem-vancomycin for at least 48h. The study's primary outcome was the incidence of acute kidney injury (AKI), defined by the Kidney Disease: Improving Global Outcomes (KDIGO) in patients with baseline normal renal function as an increase in serum creatinine (Scr) by ≥0.3mg/dl within 48h. A total of 183 patients were evaluated for AKI. The incidence of AKI was higher but not statistically different in the PT-vancomycin group (7.41%) compared with the meropenem-vancomycin group (5.33%). This study was not able to detect a statistically significant difference in AKI between the two treatment groups. A larger prospective study is warranted.
本研究旨在评估接受哌拉西林他唑巴坦(PT)和万古霉素或美罗培南和万古霉素至少 48 小时的成年患者中急性肾损伤(AKI)的观察发生率。在这项回顾性队列研究中,我们纳入了无已知肾功能障碍且至少接受 48 小时 PT-万古霉素或美罗培南-万古霉素联合治疗的成年患者。该研究的主要结局是急性肾损伤(AKI)的发生率,根据基线肾功能正常患者的肾脏疾病:改善全球结局(KDIGO)标准,定义为在 48 小时内血清肌酐(Scr)升高≥0.3mg/dl。共有 183 名患者接受 AKI 评估。PT-万古霉素组的 AKI 发生率较高,但与美罗培南-万古霉素组相比差异无统计学意义(7.41%比 5.33%)。本研究未能检测到两组间 AKI 的统计学显著差异。需要更大规模的前瞻性研究。