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薬理と治療
Abstract
Background Empirical antimicrobial therapy in the treatment of infectious diseases can target both methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, often with a combination of broad-spectrum antimicrobials and vancomycin(VCM). Recently, it was reported that VCM causes acute kidney injury (AKI)when used in combination with tazobactam -piperacillin(TAZ/PIPC). While VCM is also used in combination with meropenem (MEPM)and cefepime(CFPM), there have been no reports of AKI in these groups of patients according to a comparison among these three groups during the same period in Japan. Methods In this study, we compared the incidence of AKI among the TAZ╱PIPC group, MEPM group, and CFPM group, all of which are used in combination with VCM. The subjects were patients who used the combination of VCM and each antimicrobial from April 2015 to March 2017 in Fukuoka University Hospital. Results The incidence of AKI was 29.7% in the TAZ╱PIPC group, which was significantly higher than that in the other groups(P<0.01). The average occurrence of AKI was 3.4 days (median: 3 days)after the start of combination therapy. Conclusions The present findings suggest that when VCM is administered with TAZ╱PIPC in combination, not only should the blood concentration of VCM be noted, but the renal function should also be closely monitored early after the start of administration.
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