ArticleJournal of the American Society of Nephrology : JASN2019
Piperacillin/Tazobactam and Antibiotic-Associated Acute Kidney Injury in Critically Ill Children.
Article in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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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.
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Who cites it
17 citing papers in PubMed, 35 citations in OpenAlex.
- Piperacillin-tazobactam-associated thrombocytopenia with negative antiplatelet antibody testing: a case report and literature review.Frontiers in medicine · 2026Article
- Exploring the risks of cefepime in acute kidney injury for pediatric and young adult critical care.Pediatric nephrology (Berlin, Germany) · 2025Article
- Article
- Incidence of Antimicrobial-Associated Acute Kidney Injury in Children: A Structured Review.Paediatric drugs · 2024Review
- Mechanisms of Piperacillin/Tazobactam Nephrotoxicity: Piperacillin/Tazobactam-Induced Direct Tubular Damage in Mice.Antibiotics (Basel, Switzerland) · 2023Article
- Relationship between piperacillin concentrations, clinical factors and piperacillin/tazobactam-associated acute kidney injury.The Journal of antimicrobial chemotherapy · 2023Article
- Chronic Kidney Disease, Urinary Tract Infections and Antibiotic Nephrotoxicity: Are There Any Relationships?Medicina (Kaunas, Lithuania) · 2022Review
- β-lactam precision dosing in critically ill children: Current state and knowledge gaps.Frontiers in pharmacology · 2022Review
- Drug-induced kidney injury in Chinese critically ill pediatric patients.Frontiers in pharmacology · 2022Article
- Lowered Risk of Nephrotoxicity through Intervention against the Combined Use of Vancomycin and Tazobactam/Piperacillin: A Retrospective Cohort Study.Microbiology spectrum · 2021Article
- Acute kidney injury.Nature reviews. Disease primers · 2021Review
- Evaluating and Mitigating Risk of Acute Kidney Injury with the Combination of Vancomycin and Piperacillin-Tazobactam in Children.Paediatric drugs · 2021Review
- Vancomycin-Associated Tubular Casts and Vancomycin Nephrotoxicity.Kidney international reports · 2021Article
- Incidence and Risk Factors for Acute Kidney Injury in Hospitalized Children Receiving Piperacillin-Tazobactam.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
- Perioperative Renoprotection: General Mechanisms and Treatment Approaches.Anesthesia and analgesia · 2020Review
- Evaluation of the risk of acute kidney injury with the use of piperacillin/tazobactam among adult critically ill patients.Infection · 2020Article
- The association of acute kidney injury with the concomitant use of vancomycin and piperacillin/tazobactam in children: A systematic review and meta-analysis.Antimicrobial agents and chemotherapy · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThere continues to be uncertainty about whether piperacillin/tazobactam (TZP) increases the risk of AKI in critically ill pediatric patients. We sought to compare rates of AKI among critically ill children treated with TZP or cefepime, an alternative frequently used in intensive care units, with and without vancomycin.
methodsWe conducted a retrospective cohort study assessing the risk of AKI in pediatric intensive care unit patients after exposure to vancomycin, TZP, and cefepime, alone or in combination, within 48 hours of admission. The primary outcome was development of stage 2 or 3 AKI or an increase in AKI stage from 2 to 3 within the 6 days after the 48-hour exposure window. Secondary outcomes included lengths of stay, need for RRT, and mortality.
resultsOf 5686 patients included, 494 (8.7%) developed stage 2 or 3 AKI. The adjusted odds of developing AKI after medication exposure were 1.56 for TZP (95% confidence interval [95% CI], 1.23 to 1.99), 1.13 for cefepime (95% CI, 0.79 to 1.64), and 0.86 for vancomycin (95% CI, 0.69 to 1.07). The adjusted odds of developing AKI for vancomycin plus TZP versus vancomycin plus cefepime was 1.38 (95% CI, 0.85 to 2.24).
conclusionsObservational data in critically ill children show that TZP use is associated with increased odds of AKI. A weaker, nonsignificant association between vancomycin plus TZP and AKI compared with vancomycin plus cefepime, creates some uncertainty about the nature of the association between TZP and AKI. However, cefepime is an alternative not associated with AKI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.