BACKGROUND: This study aims to investigate renal toxicities of Polymyxin B and Vancomycin among critically ill patients and risk factors for acute kidney injury (AKI). METHODS: This is a cross-sectional study conducted with patients admitted to an intensive care unit (ICU) of a tertiary hospital in Brazil. Patients were divided into two groups: those who used association of Polymyxin B + Vancomycin (Group I) and those who used only Polymyxin B (Group II). Risk factors for AKI were also analyzed. RESULTS: A total of 115 patients were included. Mean age was 59.2 ± 16.1 years, and 52.2% were males. Group I presented higher GFR (117.1 ± 70.5 vs. 91.5 ± 50 ml/min/1.73 m², p = 0.02) as well as lower creatinine (0.9 ± 0.82 vs. 1.0 ± 0.59 mg/dL, p = 0.014) and urea (51.8 ± 23.7 vs. 94.5 ± 4.9 mg/dL, p = 0.006) than group II on admission. Group I also manifested significantly higher incidence of AKI than group II (62.7% vs. 28.5%, p = 0.005), even when stratified according to RIFLE criteria ('Risk' 33.9% vs. 10.7%; 'Injury' 10.2% vs. 8.9%; 'Failure' 18.6% vs. 8.9%; p = 0.03). Accumulated Polymyxin B dose > 10 million IU was an independent predictor for AKI (OR = 2.72, 95% CI = 1.13-6.51, p = 0.024). CONCLUSIONS: Although patients who received Polymyxin B plus vancomycin had more favorable clinical profile and higher previous GFR, they presented a higher AKI incidence than those patients who received Polymyxin B alone. Cumulative Polymyxin B dose > 10 million IU was independently associated to AKI.
BACKGROUND: This study aims to investigate renal toxicities of Polymyxin B and Vancomycin among critically illpatients and risk factors for acute kidney injury (AKI). METHODS: This is a cross-sectional study conducted with patients admitted to an intensive care unit (ICU) of a tertiary hospital in Brazil. Patients were divided into two groups: those who used association of Polymyxin B + Vancomycin (Group I) and those who used only Polymyxin B (Group II). Risk factors for AKI were also analyzed. RESULTS: A total of 115 patients were included. Mean age was 59.2 ± 16.1 years, and 52.2% were males. Group I presented higher GFR (117.1 ± 70.5 vs. 91.5 ± 50 ml/min/1.73 m², p = 0.02) as well as lower creatinine (0.9 ± 0.82 vs. 1.0 ± 0.59 mg/dL, p = 0.014) and urea (51.8 ± 23.7 vs. 94.5 ± 4.9 mg/dL, p = 0.006) than group II on admission. Group I also manifested significantly higher incidence of AKI than group II (62.7% vs. 28.5%, p = 0.005), even when stratified according to RIFLE criteria ('Risk' 33.9% vs. 10.7%; 'Injury' 10.2% vs. 8.9%; 'Failure' 18.6% vs. 8.9%; p = 0.03). Accumulated Polymyxin B dose > 10 million IU was an independent predictor for AKI (OR = 2.72, 95% CI = 1.13-6.51, p = 0.024). CONCLUSIONS: Although patients who received Polymyxin B plus vancomycin had more favorable clinical profile and higher previous GFR, they presented a higher AKI incidence than those patients who received Polymyxin B alone. Cumulative Polymyxin B dose > 10 million IU was independently associated to AKI.
Entities:
Keywords:
Polymyxin B; acute kidney injury; drug toxicity; vancomycin
Authors: Timothy P Gauthier; William R Wolowich; Arathi Reddy; Ennie Cano; Lilian Abbo; Laura B Smith Journal: Antimicrob Agents Chemother Date: 2012-02-27 Impact factor: 5.191
Authors: Kirsi-Maija Kaukonen; Michael Bailey; David Pilcher; D Jamie Cooper; Rinaldo Bellomo Journal: N Engl J Med Date: 2015-03-17 Impact factor: 91.245
Authors: Timothy P Hanrahan; Georgina Harlow; James Hutchinson; Joel M Dulhunty; Jeffrey Lipman; Tony Whitehouse; Jason A Roberts Journal: Crit Care Med Date: 2014-12 Impact factor: 7.598
Authors: Sean M Bagshaw; Kevin B Laupland; Christopher J Doig; Garth Mortis; Gordon H Fick; Melissa Mucenski; Tomas Godinez-Luna; Lawrence W Svenson; Tom Rosenal Journal: Crit Care Date: 2005-10-25 Impact factor: 9.097
Authors: Phillip J Bergen; Zackery P Bulman; Cornelia B Landersdorfer; Nicholas Smith; Justin R Lenhard; Jürgen B Bulitta; Roger L Nation; Jian Li; Brian T Tsuji Journal: Infect Dis Ther Date: 2015-12-08
Authors: Alejandra Gallardo-Godoy; Craig Muldoon; Bernd Becker; Alysha G Elliott; Lawrence H Lash; Johnny X Huang; Mark S Butler; Ruby Pelingon; Angela M Kavanagh; Soumya Ramu; Wanida Phetsang; Mark A T Blaskovich; Matthew A Cooper Journal: J Med Chem Date: 2016-01-27 Impact factor: 7.446
Authors: Josiane F John; Diego R Falci; Maria Helena Rigatto; Renata D Oliveira; Thaysa G Kremer; Alexandre P Zavascki Journal: Antimicrob Agents Chemother Date: 2017-12-21 Impact factor: 5.191