Does the Combination of Vancomycin and Piperacillin-Tazobactam Result in Excess Nephrotoxicity?

Combination vancomycin (VAN) and piperacillin-tazobactam (PTZ) is an often-used empirical antibiotic regimen for severe infections in hospitalized patients; however, both drugs can be nephrotoxic. In this retrospective study, researchers evaluated whether the combination of PTZ and VAN conferred additive risk for acute kidney injury (AKI), as defined by the RIFLE criteria (Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function, End-stage kidney disease; Crit Care 2004; 8:R204). The study involved 11,650 patients without baseline renal disease who received at least 48 hours of VAN, PTZ, or both.

RIFLE-defined AKI occurred in 14% of the overall study population: 8% of patients who received VAN mono…