title: Prospective Comparison of Acute Kidney Injury During Treatment With the Combination of Piperacillin-Tazobactam and Vancomycin Versus the Combination of Cefepime or Meropenem and Vancomycin.
abstract: OBJECTIVE
  To prospectively evaluate the observed incidence of acute kidney injury (AKI) in adult patients receiving the combination of piperacillin-tazobactam and vancomycin versus the combination of cefepime or meropenem and vancomycin for greater than 72 hours.
  
  
  METHODS
  This was a prospective, open-label cohort study at a community academic medical center involving adult patients over a 3-month time period who received either the combination of piperacillin-tazobactam and vancomycin or the combination of cefepime or meropenem and vancomycin for greater than 72 hours. The patients were evaluated for AKI, defined using specific criteria introduced by Kidney Disease: Improving global outcomes (KDIGO) acute kidney injury work group in 2012.
  
  
  RESULTS
  A total of 85 patients receiving either antimicrobial combination were evaluated for AKI. The incidence of AKI was significantly higher in the piperacillin-tazobactam and vancomycin group (37.3%) compared with the cefepime or meropenem and vancomycin group (7.7%; χ2= 7.80, P = .005).
  
  
  CONCLUSIONS
  The result of this study suggests that the risk of developing AKI is increased in patients receiving the combination of piperacillin-tazobactam and vancomycin versus those receiving the combination of cefepime or meropenem and vancomycin.
authors.affiliation: 1 Department of Pharmacy, Clinical Coordinator of Infectious Diseases Pharmacotherapy, Kingsbrook Jewish Medical Center, Brooklyn, NY, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Peyko
authors.affiliation: 2 Department of Pharmacy, Clinical Pharmacist in Emergency Medicine, New York University Langone Hospital, New York, NY, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Smalley
authors.affiliation: 3 Department of Pharmacy, Chief Pharmacotherapy Officer, Kingsbrook Jewish Medical Center, Brooklyn, NY, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Cohen
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000188:drug therapy*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D000077723:Cefepime; D002511:Cephalosporins / Q000008:administration & dosage / Q000009:adverse effects*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects; D000077725:Piperacillin, Tazobactam Drug Combination; D011446:Prospective Studies; D013845:Thienamycins / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D000077725:Piperacillin, Tazobactam Drug Combination; D014640:Vancomycin; D000077723:Cefepime; D010397:Penicillanic Acid; D000077731:Meropenem; D010878:Piperacillin
keywords: critical care; infectious disease; internal medicine; medication safety; nephrology