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The following is a summary of “Evaluating the risk of acute kidney injury and mortality associated with concomitant use of vancomycin with piperacillin/tazobactam or meropenem in critically ill and non-critically ill patients: a systematic review and meta-analysis,” published in the January 2025 issue of Infectious Disease by Alshehri et al. 

Researchers conducted a retrospective study to compare the risk of acute kidney injury (AKI) and mortality between vancomycin/piperacillin-tazobactam combination (VPT) and vancomycin/meropenem (VM).  

They retrieved the observational studies reporting AKI and mortality incidence in patients receiving VPT or VM from PubMed, the Cochrane Library, and Web of Science, covering the period from January 2017 to September 2024. The primary outcome was AKI risk, while secondary outcomes included mortality rate, need for renal replacement therapy (RRT), and hospital length of stay (LOS). A random-effects model was used in the meta-analysis to estimate odds ratios (OR) and 95% CI for AKI, mortality, and RRT, or mean differences with 95% CI for LOS.  

The results showed 17 studies, including 80,595 patients, were analyzed. The odds of acquiring AKI were significantly higher in the VPT group compared to the VM group (OR = 2.02; 95% CI 1.56–2.62). No differences were found between VPT and VM in mortality or hospital LOS. However, the VPT group had a higher likelihood of requiring RRT than the VM group (OR = 1.55; 95% CI 1.23–1.96).  

Investigators concluded the use of VPT might be associated with an increased risk of AKI compared to vancomycin alone, emphasizing the importance of judicious antibiotic selection and close monitoring of renal function in patients receiving this combination. 

 Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-10227-0