Comparison of risk of acute kidney injury between patients receiving the combination of teicoplanin and piperacillin/tazobactam versus vancomycin and piperacillin/tazobactam

摘要

Background/purposeTo compare the risk of acute kidney injury (AKI) among patients receiving teicoplanin (TA) plus piperacillin/tazobactam (TZP) versus vancomycin (VAN) plus TZP.MethodsThis was a retrospective cohort study using electronic health records. Patients were included if a combination of glycopeptide and TZP or other selected β-lactams were used during hospitalization. In the main analysis, two study groups were identified: TA?+?TZP and VAN?+?TZP. We used 1:1 propensity score matching to control for potential confounders, and hazard ratio (HR) of AKI between study groups was calculated. We further compared the risk of AKI between patients receiving VAN?+?TZP and VAN?+?β-lactams as an auxiliary analysis to verify the validity of the study design.ResultsThe final sample contained 211 pairs of patients receiving either TA?+?TZP or VAN?+?TZP. The median dosage of TA and VAN were 10.3 and 26.7?mg/kg/day, respectively. The median trough level of VAN was 12.3?mg/L. The AKI risk in the TA?+?TZP group was similar to that in the VAN?+?TZP group (12.3% vs. 11.4%; HR?=?1.25 [0.72–2.18],p?=?0.44). The auxiliary analysis showed a higher risk of AKI in the VAN?+?TZP group than in the VAN?+?β-lactam group (13.2% vs. 9.6%; HR?=?1.63 [1.04–2.55],p?=?0.03).ConclusionOur study results showed that the risk of AKI were similar for patients receiving TA?+?TZP and VAN?+?TZP. However, low VAN and high TA dose may play a role in this finding. Further investigation on the association between AKI and TA?+?TZP is required.