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Acute Kidney Injury in a Child Receiving Vancomycin and Piperacillin/Tazobactam

Bethany W Ibach1, Emilie D Henry2, Peter N Johnson3

  • 1Texas Tech University Health Sciences Center School of Pharmacy, Abilene, Texas.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|May 21, 2016
PubMed

Insights

This case report highlights a child who developed acute kidney injury (AKI) when treated with vancomycin and piperacillin/tazobactam. Renal function improved after discontinuing the antibiotics, suggesting a drug-related adverse event.

Area of Science:

  • Pediatric Nephrology
  • Clinical Pharmacology
  • Infectious Diseases

Background:

  • Concomitant use of vancomycin and piperacillin/tazobactam is increasingly reported to cause acute kidney injury (AKI) in adults.
  • Limited data exists regarding the risk of AKI associated with this antibiotic combination in pediatric populations.

Observation:

  • An 8-year-old girl in the pediatric intensive care unit developed AKI during treatment for pneumonia with vancomycin and piperacillin/tazobactam.
  • Discontinuation of both antibiotics led to the resolution of AKI, with serum creatinine returning to baseline.
  • The patient later tolerated piperacillin/tazobactam monotherapy without evidence of renal impairment.

Findings:

  • The Naranjo probability scale indicated a probable drug-related adverse event.
  • This case suggests a potential link between vancomycin and piperacillin/tazobactam combination therapy and AKI in children.

Implications:

  • Clinicians should maintain a high index of suspicion for AKI when prescribing this antibiotic combination to pediatric patients.
  • Vigilant monitoring of renal function and vancomycin drug levels is crucial.
  • Further prospective studies are warranted to determine the incidence and characteristics of AKI in children receiving vancomycin and piperacillin/tazobactam.

Keywords:
acute kidney injurychildpiperacillin/tazobactamvancomycin

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