万古霉素与哌拉西林/他唑巴坦联合治疗致急性肾损伤的危险因素：一项回顾性研究。
Risk factors for acute kidney injury in vancomycin and piperacillin/tazobactam combination therapy: A retrospective study.
机构信息
Department of Pharmacy, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
Department of Infection Control Science, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Quality and Safety Management, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
出版信息
J Infect Chemother. 2021 Nov;27(11):1614-1620. doi: 10.1016/j.jiac.2021.07.017. Epub 2021 Aug 6.
INTRODUCTION
Combined use of vancomycin (VCM) and piperacillin/tazobactam (PIPC/TAZ) has been reported to increase the incidence of acute kidney injury (AKI). However, the risk factors associated with AKI after VCM and PIPC/TAZ (VPT) administration have not yet been identified. Therefore, we retrospectively assessed patients treated with VPT to investigate the risk factors for AKI development.
METHODS
The study involved patients who were treated with VPT from January 1, 2016 to March 31, 2020. The patients were divided into the AKI or non-AKI group. The clinical characteristics of patients and antimicrobial therapy were compared between the groups. Their association with AKI risk was evaluated using multivariate logistic regression analysis.
RESULTS
In total, 182 patients were included, with 118 in the non-AKI group and 64 in the AKI group. Therefore, the incidence of AKI was 35.2 %. The initiation of VPT combination therapy on the same day and concomitant use of vasopressors were associated with an increased risk of AKI (odds ratio [OR] 2.55, 95 % confidential interval [CI] 1.20-5.44 and OR 3.22, 95 % CI 1.31-7.89, respectively).
CONCLUSION
Our findings suggest that the concomitant use of vasopressors and initiating VPT combination therapy on the same day are likely risk factors for AKI development.
简介
已有报道称，万古霉素（VCM）与哌拉西林/他唑巴坦（PIPC/TAZ）联合使用会增加急性肾损伤（AKI）的发生率。然而，VCM 和 PIPC/TAZ（VPT）给药后与 AKI 相关的危险因素尚未确定。因此，我们回顾性评估了接受 VPT 治疗的患者，以调查 AKI 发展的危险因素。
方法
本研究纳入了 2016 年 1 月 1 日至 2020 年 3 月 31 日期间接受 VPT 治疗的患者。将患者分为 AKI 或非 AKI 组。比较两组患者的临床特征和抗菌药物治疗情况。采用多变量逻辑回归分析评估其与 AKI 风险的相关性。
结果
共纳入 182 例患者，其中非 AKI 组 118 例，AKI 组 64 例。因此，AKI 的发生率为 35.2%。VPT 联合治疗的起始时间相同和同时使用血管加压药与 AKI 的发生风险增加相关（比值比[OR]2.55，95%置信区间[CI]1.20-5.44 和 OR 3.22，95%CI 1.31-7.89）。
结论
我们的研究结果表明，同时使用血管加压药和 VPT 联合治疗的起始时间可能是 AKI 发展的危险因素。
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