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Objective: The primary safety objective is Acute Kidney Injury (AKI),  defined as an increase in serum creatinine of at least 0.5 mg/dL or  a 50% increase in serum creatinine from baseline at any time during  antibiotic therapy. The objective of this study is to assess safety of Extended Infusion  Piperacillin-tazobactam (EIPT) and vancomycin therapy versus Standard  Infusion Piperacillin-tazobactam (SIPT) and vancomycin in general  medicine patients, and to evaluate if one treatment modality predisposes  patients to a greater risk of nephrotoxicity. Setting: Data from a large academic medical center was analyzed  over a 3 month period pre and post implementation of extended infusion  piperacillin-tazobactam protocol. Design: A retrospective analysis was conducted comparing patients  admitted to the hospital with a diagnosis of Healthcare Associated  Pneumonia (HCAP) who received EIPT plus vancomycin versus SIPT  plus vancomycin. Patients: Adult hospitalized patients on combination  therapy with two or more Serum Creatinine (SCr) measurements were  included. Patients were excluded if they are less than 18 years of age,  are pregnant, or if they are on any form of dialysis including continuous  renal replacement therapy. Conclusion: A total of 241 patients were evaluated for AKI.  Safety outcomes were compared between the two treatment groups  and contributing factors for developing AKI were also assessed. The  incidence of AKI was significantly higher in the SIPT and vancomycin  group (20.0%) compared with the EIPT and vancomycin group (10.0%)  in the analysis (p=0.033). There were no significant differences in the  baseline characteristics between the groups with the exception of a  higher percentage of patients with a diagnosis of hypertension in the  EIPT and vancomycin group (p<0.05).

madridge journal of novel drug research

Safety of Extended Infusion Piperacillin-Tazobactam plus Vancomycin versus Standard Infusion Piperacillin-Tazobactam plus Vancomycin in General Medicine Patients with a diagnosis of Healthcare associated Pneumonia