Two recently presented abstracts at the 2012 Society of
Critical Care Medicine conference suggest that the combination of vancomycin
and piperacillin-tazobactam may lead to acute kidney injury (AKI) in the
critically ill. There may also be evidence to suggest that
piperacillin-tazobactam alone increases the risk of AKI.
Both abstracts retrospectively compared patients who
received either vancomycin alone or the combination of vancomycin and
piperacillin-tazobactam. In both studies, the rates of AKI were significantly
lower in patients treated with vancomycin alone as compared to patients
receiving both vancomycin and piperacillin-tazobactam.
Bottom line: Although the current evidence does not support
a change in our clinical practice, more prospective studies exploring this
topic are necessary.
Min, et al. Acute Kidney Injury in Patients Recieving Concomitant Vancomycin and Piperacillin/Tazobactam. Critical Care Medicine. December 2011. 39(12); p 200
Hellwig, et. al. Retrospective Evaluation of the Incidence of Vancomycin and/or Piperacillin-Tazobactam Induced Acute Renal Failure. Critical Care Medicine. December 2011. 39(12); p 79
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