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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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Acute Kidney Injury Associated with the Concomitant Use of Vancomycin and Piperacillin-Tazobactam

Dayu Chen1,2,3, Jingjing Kan2, Qiaoling Gu2

  • 1Department of Pharmacy, Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China.

Drug Design, Development and Therapy
|September 15, 2025
PubMed

Insights

The combination of vancomycin (VAN) and piperacillin-tazobactam (TZP) may increase acute kidney injury (AKI) risk. Research explores mechanisms and mitigation strategies for vancomycin and piperacillin-tazobactam (VPT)-associated AKI.

Area of Science:

  • Pharmacology
  • Nephrology
  • Clinical Therapeutics

Background:

  • Increased co-administration of vancomycin (VAN) and piperacillin-tazobactam (TZP) is linked to acute kidney injury (AKI) concerns.
  • The precise mechanisms driving vancomycin and piperacillin-tazobactam (VPT)-associated AKI are not fully understood.
  • Conflicting outcomes exist in the literature regarding the association between VPT and AKI risk.

Purpose of the Study:

  • To review controversial and underexplored aspects of VPT-associated AKI.
  • To elucidate potential mechanisms contributing to VPT-induced AKI.
  • To outline strategies for mitigating the risk of VPT-induced AKI.

Main Methods:

  • Review of existing clinical observations and animal studies.
  • Analysis of proposed mechanisms for VPT-associated AKI.
  • Exploration of pharmacovigilance insights.

Main Results:

  • Proposed mechanisms include additive toxic effects, increased VAN exposure, exacerbated oxidative stress, and impaired creatinine secretion.
  • Multiple factors may contribute to VPT-induced AKI.
  • Evidence suggests a potential link between VPT and increased AKI risk, though conflicting data exists.

Conclusions:

  • Understanding the complex mechanisms of VPT-associated AKI is crucial.
  • Further research is needed to clarify conflicting outcomes.
  • Developing effective mitigation strategies is essential for patient safety and pharmacovigilance.
Keywords:
acute kidney injuryconcomitant therapynephrotoxicitypiperacillin-tazobactamvancomycin

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