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Updated: Dec 22, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

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[Combinatorial Vancomycin and Piperacillin/Tazobactam Results in Elevated Vancomycin Trough Concentration and Acute

Yoshiro Sakai1,2, Ryoko Miwa1, Masahiro Mitsuoka3

  • 1Department of Pharmacy, Kurume University Hospital.

Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan
|May 8, 2020
PubMed

Insights

This case study highlights antibiotic-induced acute kidney injury (AKI) in a patient treated with vancomycin and piperacillin/tazobactam. The combination led to elevated vancomycin levels and AKI, emphasizing careful monitoring.

Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Antibiotics are crucial for treating hospital-acquired infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA).
  • Acute kidney injury (AKI) is a potential complication of antibiotic therapy.

Observation:

  • A 30-year-old male with MRSA infection and complications received vancomycin and piperacillin/tazobactam.
  • The patient developed AKI with elevated vancomycin trough concentrations.
  • Renal function improved after discontinuing both antibiotics.

Findings:

  • This case suggests a drug-drug interaction between vancomycin and piperacillin/tazobactam, leading to AKI.
  • An unexpected increase in vancomycin levels occurred even after halting treatment.
  • Concurrent renal stressors may have contributed to the observed nephrotoxicity.

Implications:

  • Close monitoring of vancomycin trough concentrations and renal function is essential when co-administered with piperacillin/tazobactam.
  • Minimizing the combined use of these antibiotics may prevent AKI.
  • This interaction warrants further investigation in clinical practice.
Keywords:
acute kidney injurypiperacillin/tazobactamvancomycinvancomycin trough concentration

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