Comparative Risk of Acute Kidney Injury Following Concurrent Administration of Vancomycin with Piperacillin/Tazobactam or Meropenem: A Systematic Review and Meta-Analysis of Observational Studies

Comparative Risk of Acute Kidney Injury Following Concurrent Administration of Vancomycin with Piperacillin/Tazobactam or Meropenem: A Systematic Review and Meta-Analysis of Observational Studies

The study aims to comparatively assess the nephrotoxicity of vancomycin when combined with piperacillin-tazobactam (V + PT) or meropenem (V + M) in adult patients hospitalized in general wards or intensive care units. We searched MEDLINE, Google Scholar, and Web of Science for observational studies...

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Bibliographic Details
Published in:Antibiotics (Basel) Vol. 11; no. 4; p. 526
Main Authors: Alshehri, Abdulmajeed M, Alzahrani, Mohammed Y, Abujamal, Mohammed A, Abdalla, Mariam H, Alowais, Shuroug A, Alfayez, Osamah M, Alyami, Majed S, Almutairi, Abdulaali R, Almohammed, Omar A
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 14-04-2022
MDPI
Subjects:
acute kidney injury
Antibiotics
Confidence intervals
Health risks
Hospitals
Intensive care
Intensive care units
Kidney diseases
Meropenem
Meta-analysis
Mortality
nephrotoxicity
Observational studies
Pathogens
Patients
Piperacillin
Piperacillin-tazobactam
Renal replacement therapy
Risk
Search engines
Staphylococcus infections
Tazobactam
Vancomycin
meropenem
vancomycin
acute kidney injury
nephrotoxicity
piperacillin-tazobactam
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Summary:The study aims to comparatively assess the nephrotoxicity of vancomycin when combined with piperacillin-tazobactam (V + PT) or meropenem (V + M) in adult patients hospitalized in general wards or intensive care units. We searched MEDLINE, Google Scholar, and Web of Science for observational studies evaluating incidences of AKI in adult patients receiving V + PT or V + M for at least 48 h in general wards or intensive care units. The primary outcome was AKI events, while the secondary outcomes were hospital length of stay, need for renal replacement therapy (RRT), and mortality events. The odds ratio (OR), or mean difference for the hospital length of stay, with a corresponding 95% confidence interval (CI) from the inverse variance weighting random-effects model were estimated for the risk of AKI, RRT, and mortality. Of the 112 studies identified, twelve observational studies were included in this meta-analysis with a total of 14,511 patients. The odds of having AKI were significantly higher in patients receiving V + PT compared with V + M (OR = 2.31; 95%CI 1.69-3.15). There were no differences between V + PT and V + M in the hospital length of stay, RRT, or mortality outcomes. Thus, clinicians should be vigilant while using V + PT, especially in patients who are at high risk of AKI.
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ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics11040526