Review
Urology & Nephrology
Matthew Blair, Jean-Maxime Cote, Aoife Cotter, Breda Lynch, Lynn Redahan, Patrick T. Murray
Summary: Recent studies have shown that the combination of vancomycin with piperacillin-tazobactam (VPT) is associated with increased nephrotoxicity. Strategies to minimize the risk of toxicity include antimicrobial stewardship, monitoring of kidney function, and the use of novel biomarkers for predicting and managing AKI.
AMERICAN JOURNAL OF NEPHROLOGY
(2021)
Article
Medicine, General & Internal
Chi-Hao Shao, Chih-Hsun Tai, Fang-Ju Lin, Chien-Chih Wu, Jann-Tay Wang, Chi-Chuan Wang
Summary: This study compared the risk of AKI among patients receiving TA + TZP and VAN + TZP, finding similar risks between the two groups, but slightly higher AKI risk in the VAN + TZP group compared to the VAN + 3-lactam group. Further investigation is needed to explore the association between AKI and TA + TZP.
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
(2022)
Review
Health Care Sciences & Services
Abdullah Tarik Aslan, Murat Akova
Summary: Numerous studies have shown that combination therapy of piperacillin-tazobactam and vancomycin is associated with an increased risk of acute kidney injury. However, the exact mechanisms and causality of this association are still unclear. Although there are limitations in the current studies, preventive measures can be taken to reduce the risk of acute kidney injury when using this combination therapy.
Article
Surgery
Talal B. Seddik, Lauren A. Rabsatt, Claudia Mueller, Hannah K. Bassett, Despina Contopoulos-Ioannidis, Laura L. Bio, Victor D. Anderson, Hayden T. Schwenk
Summary: Provider education and modification of electronic antibiotic orders safely reduced the use of piperacillin and tazobactam for pediatric perforated appendicitis. There were no significant differences in the duration of antibiotic therapy, length of stay, surgical site infection rate, or 30-day readmission and emergency department visit rate between preintervention and postintervention periods.
JOURNAL OF SURGICAL RESEARCH
(2021)
Article
Infectious Diseases
Abdullah Tarik Aslan, Tural Pashayev, Osman Dag, Murat Akova
Summary: This study compared the impact of different antibiotic combinations on acute kidney injury (AKI). The results showed that teicoplanin is preferred over vancomycin when combined with TZP to reduce the risk of AKI occurrence. However, there were no significant differences in other aspects such as mortality rates and AKI resolution rates.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2021)
Review
Infectious Diseases
Abdulmajeed M. Alshehri, Mohammed Y. Alzahrani, Mohammed A. Abujamal, Mariam H. Abdalla, Shuroug A. Alowais, Osamah M. Alfayez, Majed S. Alyami, Abdulaali R. Almutairi, Omar A. Almohammed
Summary: The study found that combining vancomycin with piperacillin-tazobactam increases the risk of acute kidney injury in adult patients, while combining it with meropenem shows no significant difference. Clinicians should be cautious in using V + PT, especially in patients at high risk of AKI.
Article
Infectious Diseases
Sonya Tang Girdwood, Denise Hasson, J. Timothy Caldwell, Cara Slagle, Shun Dong, Lin Fei, Peter Tang, Alexander A. Vinks, Jennifer Kaplan, Stuart L. Goldstein
Summary: This study investigated the exposure of piperacillin/tazobactam in critically ill children and young adults, and identified clinical factors associated with piperacillin-associated acute kidney injury (AKI). The results showed that higher piperacillin AUC and highest C-min in the first 24 hours were associated with piperacillin-associated AKI, indicating the importance of early total piperacillin exposure in AKI development.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Article
Immunology
Stephanie M. Cabral, Anthony D. Harris, Sara E. Cosgrove, Laurence S. Magder, Pranita D. Tamma, Katherine E. Goodman
Summary: This study assessed adherence to surgical antimicrobial prophylaxis guidelines in US hospitals and found that unnecessary vancomycin use was common and increased the risk of acute kidney injury. Between 2019 and 2020, 41% of elective surgeries in 825 US hospitals did not adhere to prophylaxis guidelines.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Infectious Diseases
Chih-Hsun Tai, Chi-Hao Shao, Chi-Chuan Wang, Fang-Ju Lin, Jann-Tay Wang, Chien-Chih Wu
Summary: This retrospective cohort study compared the risk of AKI between teicoplanin-piperacilin/tazobactam and teicoplanin-OAPBs combination therapy, finding no significant difference in AKI risk between the two treatment combinations.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Article
Infectious Diseases
Savera Arain, Fahad Khalawi, Sainul Abideen Parakkal, Hassan S. S. AlHamad, Shabeer Ali Thorakkattil, Faisal Fahad J. Alghashmari, Bader AlHarbi, Nujud Bakhashwain, Weaam Mustafa Alzawad, Ali AlHomoud
Summary: This study aimed to evaluate the utilization practice of piperacillin/tazobactam in a hospital setting and assess the impact of pharmacist intervention. The results showed that inappropriate usage of piperacillin/tazobactam was improved with pharmacist intervention, including dose optimization, timely bacterial culture orders, prompt de-escalation, and adherence to extended infusion guidelines. The study highlighted the important role of pharmacists in improving the quality and safety of medication use in healthcare organizations globally.
Article
Microbiology
Patrick S. Kiley, Aaron P. Pearston, Laura A. Hodge, Marcus C. Kaplan, Stephanie M. Baczek, James S. Stanley, Tyler J. Wilson, Kristina M. Soriano, Andrew Yao, Zachary A. Shaeffer, Irene E. Tait, Joshua A. Cohen, Amanda I. Ingemi
Summary: This study evaluated the incidence of acute kidney injury (AKI) in patients receiving vancomycin with either piperacillin-tazobactam or meropenem or cefepime. The results showed that the incidence of AKI was significantly higher with vancomycin and piperacillin-tazobactam compared to vancomycin with meropenem or cefepime.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Article
Medicine, General & Internal
R. F. Tookhi, N. A. Kabli, M. A. Huntul, A. K. Thabit
Summary: This study aimed to evaluate the rate of acute kidney injury (AKI) in patients receiving either VAN with TZP or VAN with MEM, finding a higher AKI rate but non-significant difference in the VAN-MEM group compared to the VAN-TZP group. In-hospital mortality was higher in the VAN-MEM group, possibly due to a higher percentage of critically ill patients in that group.
INTERNAL AND EMERGENCY MEDICINE
(2021)
Article
Immunology
Sara Alosaimy, Abdalhamid M. Lagnf, Athena L. Hobbs, Musa Mubarez, Wesley D. Kufel, Taylor Morrisette, Radhika S. Polisetty, David Li, Michael P. Veve, Sam P. Simon, James Truong, Natalie Finch, Veena Venugopalan, Matthew Rico, Lee Amaya, Christine Yost, Ashley Cubillos, Elisabeth Chandler, Megan Patch, Ian Murphy Kelsey Smith, Mark Biagi, Justin Wrin, W. Justin Moore, Kyle C. Molina, Nicholas Rebold, Dana Holger, Ashlan J. Kunz Coyne, Sarah Jorgensen, Paige Witucki, Nikki N. Tran, Susan L. Davis, George Sakoulas, Michael J. Rybak
Summary: This study compared the incidence of acute kidney injury (AKI) when vancomycin was combined with piperacillin-tazobactam (VAN-TZP) versus when it was combined with ceftolozane-tazobactam (VAN/C/T). The results showed that VAN-TZP was associated with a higher risk of AKI compared to VAN/C/T.
CLINICAL INFECTIOUS DISEASES
(2023)
Review
Pediatrics
Emma M. Tillman, Jennifer L. Goldman
Summary: This review discusses the potential increased risk of acute kidney injury associated with the antibiotic combination of vancomycin and piperacillin-tazobactam in pediatric patients, highlighting limitations in existing studies and providing guidance for clinicians in mitigating this risk. If used as an empirical antibiotic combination, caution should be exercised in selecting patients at low risk for AKI and extra vigilance in those with additional nephrotoxic risks. Systems should be in place for monitoring renal function in patients receiving this combination.
Article
Critical Care Medicine
Todd A. Miano, Sean Hennessy, Wei Yang, Thomas G. Dunn, Ariel R. Weisman, Oluwatosin Oniyide, Roseline S. Agyekum, Alexandra P. Turner, Caroline A. G. Ittner, Brian J. Anderson, F. Perry Wilson, Raymond Townsend, John P. Reilly, Heather M. Giannini, Christopher Cosgriff, Tiffanie K. Jones, Nuala J. Meyer, Michael G. S. Shashaty
Summary: The study suggests that the combination of vancomycin and piperacillin-tazobactam may increase the risk of acute kidney injury, but does not significantly affect alternative kidney biomarkers, dialysis, or mortality. This supports the hypothesis that the effects of vancomycin and piperacillin-tazobactam on creatinine represent pseudotoxicity.
INTENSIVE CARE MEDICINE
(2022)