Related Experiment Video

Updated: Jul 5, 2025

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

4.5K

Association of piperacillin and vancomycin exposure on acute kidney injury during combination therapy

Veena Venugopalan1,2, Nicole Maranchick2, Devorah Hanai2

  • 1Department of Pharmacy, UF Health Shands Hospital, Gainesville, FL, USA.

Jac-Antimicrobial Resistance
|January 23, 2024
PubMed
Abstract

Insights

This study found no significant pharmacokinetic differences in vancomycin and piperacillin/tazobactam exposure between patients with and without acute kidney injury (AKI). These findings suggest the combination therapy can be used cautiously, without fear of overexposure contributing to AKI.

Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Acute kidney injury (AKI) is a known adverse effect of combined vancomycin and piperacillin/tazobactam therapy.
  • The pharmacokinetic profiles of this antibiotic combination in relation to AKI have not been thoroughly investigated.
  • Understanding drug exposure is crucial for managing potential nephrotoxicity.

Purpose of the Study:

  • To compare vancomycin and piperacillin/tazobactam exposure in patients who developed AKI versus those who did not.
  • To evaluate the pharmacokinetic differences associated with the combination therapy in the presence or absence of nephrotoxicity.

Main Methods:

  • Ninety adult patients receiving vancomycin plus piperacillin/tazobactam for at least 72 hours were analyzed.
  • Nephrotoxicity was defined as a 1.5-fold increase in serum creatinine within 7 days.
  • Median daily area under the curve (AUC) for vancomycin and piperacillin were calculated and compared between groups.

Main Results:

  • The overall incidence of AKI was 20% (18/90).
  • No significant differences in median daily vancomycin AUCs were observed between patients with and without AKI.
  • Piperacillin AUCs did not differ significantly, except on Day 7 where the AKI group had lower exposure.

Conclusions:

  • This study did not identify significant differences in vancomycin or piperacillin/tazobactam exposure related to AKI.
  • The findings suggest that the combination therapy does not necessarily lead to overexposure in patients developing AKI.
  • Clinicians should continue to administer vancomycin and piperacillin/tazobactam cautiously, monitoring renal function closely.

More Related Videos

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research03:13

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

Published on: November 3, 2023

2.2K
Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish13:25

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish

Published on: May 15, 2021

5.7K

Related Concept Videos

Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
3.9K
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
89
Drug Elimination by Renal Route: Tubular Secretion01:15

Drug Elimination by Renal Route: Tubular Secretion

Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
2.4K
Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa01:22

Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa

The pH of urine, the drug's pKa, and the urine flow rate are vital parameters for drug reabsorption and excretion. Urinary pH varies between 4.6 and 8.0 and is influenced by diet, drug intake, and the patient's pathophysiology. It affects a drug's ionization state and reabsorption. For instance, carbohydrate-rich food produces alkaline urine promoting drug excretion, while proteins and certain medications like ascorbic acid lead to acidic urine enhancing reabsorption.
The pKa of a...
172