Incidence of acute kidney injury among pediatric hematology/oncology patients receiving vancomycin in combination with piperacillin/tazobactam or cefepime

Pediatr Blood Cancer. 2019 Jul;66(7):e27750. doi: 10.1002/pbc.27750. Epub 2019 Apr 16.

Abstract

There is mounting evidence that combination of antibiotic therapy with vancomycin and piperacillin/tazobactam (pip/tazo) is associated with acute kidney injury (AKI). To determine whether vancomycin plus pip/tazo is associated with higher rates of AKI compared to vancomycin plus cefepime among pediatric hematology/oncology (heme/onc) patients, we examined 121 heme/onc patients receiving at least two consecutive days of therapy with vancomycin and either pip/tazo or cefepime. Rate of AKI was higher in the pip/tazo than the cefepime group (4/27 [14.8%] vs 2/94 [2.1%], P = 0.022).

Keywords: acute kidney injury; cefepime; hematology/oncology; infections; piperacillin/tazobactam; vancomycin.

Publication types

  • Clinical Trial

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / epidemiology
  • Adolescent
  • Cefepime / administration & dosage
  • Cefepime / adverse effects*
  • Child
  • Child, Preschool
  • Female
  • Hematologic Neoplasms* / drug therapy
  • Hematologic Neoplasms* / epidemiology
  • Humans
  • Male
  • Piperacillin / administration & dosage
  • Piperacillin / adverse effects*
  • Retrospective Studies
  • Tazobactam / administration & dosage
  • Tazobactam / adverse effects*
  • Vancomycin / administration & dosage
  • Vancomycin / adverse effects*

Substances

  • Vancomycin
  • Cefepime
  • Tazobactam
  • Piperacillin