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Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions01:09

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...

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Related Experiment Video

Updated: Jul 16, 2026

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

Factors Affecting Vancomycin and Piperacillin-Tazobactam-Induced Nephrotoxicity.

Mollie VanNatta Day1, Ruhul Munshi2, Kalyn Picard2

  • 1Ochsner LSU Health Shreveport, Academic Medical Center, 1541 Kings Highway, Shreveport, LA 71103, USA.

Journal of Clinical Medicine
|July 15, 2026
PubMed
Summary

The combination of vancomycin and piperacillin-tazobactam can cause acute kidney injury (AKI) in 25.4% of patients. Higher body mass index (BMI) and intravenous (IV) contrast use increase nephrotoxicity risk.

Keywords:
antimicrobial stewardshipnephrotoxicitypiperacillin–tazobactamvancomycin

Related Experiment Videos

Last Updated: Jul 16, 2026

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

Area of Science:

  • Nephrology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Vancomycin and piperacillin-tazobactam combination nephrotoxicity is debated.
  • The specific impact on acute kidney injury (AKI) is uncertain.
  • Identifying risk factors for nephrotoxicity is crucial.

Purpose of the Study:

  • To investigate the incidence of AKI in patients receiving vancomycin and piperacillin-tazobactam.
  • To identify determinants of AKI in this patient population.

Main Methods:

  • Retrospective cohort study (May 2019-March 2023).
  • Included adult patients receiving dual therapy for ≥48 hours.
  • Compared demographic features, concomitant nephrotoxic agents, infection site, vasopressor use, therapy duration, and vancomycin levels between AKI and non-AKI groups.

Main Results:

  • AKI occurred in 25.4% of 350 patients.
  • Elevated vancomycin trough/AUC/MIC, higher BMI, and IV contrast use were associated with AKI.
  • African American patients showed a higher incidence of AKI (51.7%).

Conclusions:

  • Vancomycin and piperacillin-tazobactam combination therapy is associated with a 25.4% AKI incidence.
  • Higher BMI and IV contrast use are significant risk factors for nephrotoxicity.
  • Caution is advised when using this combination in patients with elevated BMI or prior IV contrast exposure.