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

Abstract

To compare the risk of acute kidney injury (AKI) among patients receiving teicoplanin (TA) plus piperacillin/tazobactam (TZP) versus vancomycin (VAN) plus TZP. This 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. The 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 26.7mg/kg/day, respectively. The median trough level of VAN was 12.3mg/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). Our 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.