ArticleJournal of hospital medicine2017
Acute kidney injury in patients treated with vancomycin and piperacillin-tazobactam: A retrospective cohort analysis.
Article in Journal of hospital medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05094154 (Effect of Antibiotic Choice On ReNal Outcomes), which is not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Antibiotic Choice On ReNal Outcomes (ACORN)
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Association between concomitant use of vancomycin-piperacillin/tazobactam and acute kidney injury in real-world setting.Frontiers in physiology · 2026Pooled it
- Xuebijing alleviates high-voltage electrical burn-induced acute kidney injury by inhibiting neutrophils and inflammation.Scientific reports · 2025Trial
- Incidence of acute kidney injury among pediatric hematology/oncology patients receiving vancomycin in combination with piperacillin/tazobactam or cefepime.Pediatric blood & cancer · 2019Trial
- Unraveling Acute Kidney Injury: An Intricate Case of Sepsis and Immune-Mediated Renal Damage.Cureus · 2025Article
- Effect modification of dosing strategy (AUC or trough) on AKI associated with vancomycin in combination with piperacillin/tazobactam or cefepime and meropenem.Antimicrobial agents and chemotherapy · 2024Article
- Article
- Piperacillin-Tazobactam Versus Anti-Pseudomonal Cephalosporins and Renal and Neurologic Outcomes in Critically Ill Adults: A Secondary Analysis of the SMART Trial.Journal of intensive care medicine · 2023Article
- The Risk and Clinical Implications of Antibiotic-Associated Acute Kidney Injury: A Review of the Clinical Data for Agents with Signals from the Food and Drug Administration's Adverse Event Reporting System (FAERS) Database.Antibiotics (Basel, Switzerland) · 2022Review
- Advances in Sepsis Care.Clinics in chest medicine · 2022Review
- Piperacillin-Tazobactam Plus Vancomycin-Associated Acute Kidney Injury in Adults: Can Teicoplanin or Other Antipseudomonal Beta-Lactams Be Remedies?Healthcare (Basel, Switzerland) · 2022Review
- Comparative Risk of Acute Kidney Injury Following Concurrent Administration of Vancomycin with Piperacillin/Tazobactam or Meropenem: A Systematic Review and Meta-Analysis of Observational Studies.Antibiotics (Basel, Switzerland) · 2022Article
- Progression of Kidney Injury with the Combination of Vancomycin and Piperacillin-Tazobactam or Cefepime in Sepsis-Associated Acute Kidney Injury.Frontiers in nephrology · 2022Article
- Vancomycin Loading Doses and Nephrotoxicity on Medicine Teaching Services.International journal of general medicine · 2022Article
- Comparison of teicoplanin versus vancomycin in combination with piperacillin-tazobactam or meropenem for the risk of acute kidney injury.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- [Safety in the selection of oral antibiotic treatment in community infections, beyond COVID-19].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Review
- Beta-Lactams Toxicity in the Intensive Care Unit: An Underestimated Collateral Damage?Microorganisms · 2021Review
- Risk of Acute Kidney Injury in Combat-Injured Patients Associated With Concomitant Vancomycin and Extended-Spectrum β-Lactam Antibiotic Use.Journal of intensive care medicine · 2021Article
- Safety of Dalbavancin in the Treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSI): Nephrotoxicity Rates Compared with Vancomycin: A Post Hoc Analysis of Three Clinical Trials.Infectious diseases and therapy · 2021Article
- Nephrotoxicity of concomitant piperacillin/tazobactam and teicoplanin compared with monotherapy.The Journal of antimicrobial chemotherapy · 2021Article
- The Incidence, Characteristics, and Use of Suspected Nephrotoxic Drugs in Elderly Patients with Community-Acquired Acute Kidney Injury.Clinical interventions in aging · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEmpiric antimicrobial therapy often consists of the combination of gram-positive coverage with vancomycin (VAN) and gram-negative coverage, specifically an antipseudomonal beta-lactam such as piperacillin-tazobactam (PTZ). Nephrotoxicity is commonly associated with VAN therapy; however, recent reports show higher nephrotoxicity rates among patients treated with the combination of VAN and PTZ.
objectiveThis study evaluated the effect of the VAN/PTZ combination on acute kidney injury (AKI) compared to VAN and PTZ monotherapies. DESIGN, SETTING, AND PATIENTS: This is a retrospective cohort analysis of adult patients without renal disease receiving VAN, PTZ, or the combination from September 1, 2010 through August 31, 2014 at an academic medical center. MEASUREMENTS: The primary outcome was AKI incidence as defined by the Risk, Injury, Failure, Loss, End-stage (RIFLE) criteria.
methodsContinuous and categorical variables were assessed with appropriate tests. Univariate and multivariate logistic regressions were performed to assess for associations between variables and AKI incidence. Subanalyses based on severity of illness were performed.
resultsOverall, 11,650 patients were analyzed, with 1647 (14.1%) developing AKI. AKI was significantly more frequent in the VAN/PTZ group (21%) compared to either monotherapy group (VAN 8.3%, PTZ 7.8%, P ⟨ 0.001 for both). Combination therapy was independently associated with higher AKI odds compared to monotherapy with either agent (adjusted odds ratio [aOR], 2.03; 95% confidence interval [CI], 1.74-2.39; aOR, 2.31; 95% CI, 1.97-2.71, for VAN and PTZ, respectively). Receipt of concomitant nephrotoxic drugs was independently associated with increased AKI rates, as were increased duration of therapy, hospital length of stay, increasing severity of illness, and increasing baseline renal function.
conclusionsIn this study of more than 10,000 patients, VAN combined with PTZ was associated with twice the odds of AKI development compared to either agent as monotherapy. This demonstrates the need for judicious use of combination empiric therapy. Journal of Hospital Medicine 2017;12:77-82.
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