Comparison of piperacillin-tazobactam and vancomycin (TZP-VAN) with piperacillin-tazobactam and teicoplanin (TZP-TEI) for the risk of acute kidney injury (CONCOMITANT): A prospective observational, multinational, multi-centre cohort study

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dc.authoridAlkan, Sevil / 0000-0003-1944-2477
dc.contributor.authorAslan, Abdullah Tarik
dc.contributor.authorKara, Emre
dc.contributor.authorKöksal, Gamze
dc.contributor.authorBilir, Yeliz
dc.contributor.authorSaraçoğlu, Kemal Tolga
dc.contributor.authorEser, Fatma
dc.contributor.authorGüner, Rahmet
dc.contributor.authorAlkan, Sevil
dc.date.accessioned2025-05-29T02:57:59Z
dc.date.available2025-05-29T02:57:59Z
dc.date.issued2025
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractObjective: Both vancomycin (VAN) and teicoplanin (TEI) augment the risk of acute kidney injury (AKI) when combined with piperacillin-tazobactam (TZP). We aimed to compare the risk of AKI among patients receiving TZP-VAN vs. TZP-TEI. Methods: This was a prospective, multinational, multicentre cohort study conducted in 12 centres from Turkiye, Italy, and Spain between 1 June 2022, and 31 December 2023. The primary outcome was the occurrence of AKI between the first day of antibiotic treatment and the third day after completing therapy, according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression and propensity-score match analyses were employed to adjust for confounding variables. Stratified Kaplan- Meier analysis was used to assess the time-to-AKI between the comparison groups. Results: Of 187 patients (TZP-TEI, n = 102; TZP-VAN, n = 85), the AKI occurred in 21 patients (24.7%) who received TZP-VAN and in 15 patients (14.7%) with TZP-TEI (unadjusted odds ratio [OR], 1.90; 95% CI: 0.91-3.97; P = 0.087). After adjusting for confounding variables with multivariable analysis, TZP-VAN was not associated with increased odds of AKI compared with TZP-TEI; with an adjusted OR of 2.24 (95% CI: 0.78-6.42; P = 0.133). In propensity-score matched analysis ( n = 49 pairs), the AKI risk was similar between the two groups (OR, 2.10; 95% CI: 0.67-6.50; P = 0.199). The stratified Kaplan-Meier analysis indicated no difference between the treatment groups in terms of time-to-AKI (log-rank test, P = 0.107). Conclusions: The risk of AKI in TZP-VAN was similar to that in TZP-TEI. These results should be confirmed in randomized controlled trials.
dc.description.sponsorshipHacettepe University Scientific Re-search Coordination Unit [THD-2022-20012]
dc.description.sponsorshipThis study was supported by Hacettepe University Scientific Re-search Coordination Unit (Project ID: THD-2022-20012) .
dc.identifier.doi10.1016/j.ijantimicag.2025.107446
dc.identifier.issn0924-8579
dc.identifier.issn1872-7913
dc.identifier.issue3
dc.identifier.pmid39826571
dc.identifier.scopus2-s2.0-85217367757
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1016/j.ijantimicag.2025.107446
dc.identifier.urihttps://hdl.handle.net/20.500.12428/30230
dc.identifier.volume65
dc.identifier.wosWOS:001428538100001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofInternational Journal of Antimicrobial Agents
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250529
dc.subjectPiperacillin-tazobactam
dc.subjectVancomycin
dc.subjectTeicoplanin
dc.subjectAcute kidney injury
dc.subjectKDIGO
dc.subjectCreatinine
dc.titleComparison of piperacillin-tazobactam and vancomycin (TZP-VAN) with piperacillin-tazobactam and teicoplanin (TZP-TEI) for the risk of acute kidney injury (CONCOMITANT): A prospective observational, multinational, multi-centre cohort study
dc.typeArticle

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