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Acute kidney injury and vancomycin/piperacillin/tazobactam in adult patients: a systematic review

  • CE-Systematic reviews and meta-analysis
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Abstract

The aim of this systematic review was to assess AKI (acute kidney injury) in adult patients, treated with vancomycin (V) + piperacillin/tazobactam (PT) compared to V monotherapy. Studies were found in Pubmed, Web of Science and Scopus databases. Articles not in English, pediatric studies and case reports were excluded. A study is eligible for inclusion if the adjusted Odds ratio (aOR) for AKI in V + PT compared to V monotherapy groups, could be extracted or determined from available data. Six retrospective cohort studies were eligible for inclusion criteria and so they were included in the analysis. All studies separately showed a significant higher risk of developing AKI (OR > 1, p < 0.05) in V + PT group compared to V monotherapy group. Considering the methodological difference of included studies, a random effect model was preferred. The model showed a pooled significant higher risk of developing AKI [OR 2.77 (95% CI 1.94, 3.96), p < 0.0001] in V + PT group compared to V group. Association of V and PT appears to be associated with a greater risk of AKI compared to V in monotherapy. These results may serve as the impetus for further evaluation into true mechanisms behind this additive nephrotoxic effect and its potential implications on mortality.

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Authors and Affiliations

  1. Hospital of Marcianise, ASL Caserta, Marcianise, Italy

    Tiziana Ciarambino

  2. Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy

    Orazio Valerio Giannico

  3. Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138, Naples, Italy

    Amalia Campanile, Giuseppe Signoriello & Mauro Giordano

  4. Department of Internal Medicine, Hospital of Mare, Naples, Italy

    Paolo Tirelli

  5. Department of Internal Medicine, Hospital of Careggi, University of Florence, Florence, Italy

    Ombretta Para

Authors
  1. Tiziana Ciarambino
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  2. Orazio Valerio Giannico
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  3. Amalia Campanile
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  4. Paolo Tirelli
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  5. Ombretta Para
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  6. Giuseppe Signoriello
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  7. Mauro Giordano
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Correspondence to Tiziana Ciarambino.

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Ciarambino, T., Giannico, O.V., Campanile, A. et al. Acute kidney injury and vancomycin/piperacillin/tazobactam in adult patients: a systematic review. Intern Emerg Med 15, 327–331 (2020). https://doi.org/10.1007/s11739-020-02287-2

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  • DOI: https://doi.org/10.1007/s11739-020-02287-2

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