Evaluating and Mitigating Risk of Acute Kidney Injury with the Combination of Vancomycin and Piperacillin-Tazobactam in Children.

Document Type

Article

Publication Date

7-2021

Identifier

DOI: 10.1007/s40272-021-00458-y

Abstract

The antibiotic combination of vancomycin (VAN) and piperacillin-tazobactam (PTZ) has been associated with an increased risk of acute kidney injury (AKI) in both adult and pediatric patients. In this review, we highlight some of the limitations of existing pediatric studies evaluating the combination of VAN/PTZ, focusing on AKI risk in specific pediatric patient populations. We also review the variability in defining AKI in children and provide guidance to clinicians for use of prospective surveillance and stewardship in mitigating the risk of AKI in pediatric patients treated with combination of VAN/PTZ. Based on review of available pediatric studies, if the combination of VAN/PTZ is selected as an empirical antibiotic combination, it should be used in those at low risk for AKI and should be used with extreme caution in patients with additional nephrotoxic risks. Systems should be in place to monitor the use of VAN/PTZ and associated renal function in those receiving this antibiotic combination.

Journal Title

Paediatric drugs

Volume

23

Issue

4

First Page

373

Last Page

380

MeSH Keywords

Acute Kidney Injury; Anti-Bacterial Agents; Child; Drug Therapy, Combination; Humans; Piperacillin, Tazobactam Drug Combination; Prospective Studies; Retrospective Studies; Risk Factors; Vancomycin

Keywords

Acute Kidney Injury; Anti-Bacterial Agents; Combination Drug Therapy; Piperacillin, Tazobactam Drug Combination; Prospective Studies; Retrospective Studies; Risk Factors; Vancomycin

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