Incidence, associated factors, and effect on renal function of amoxicillin crystalluria in patients receiving high doses of intravenous amoxicillin (The CRISTAMOX Study): A cohort study.
Amoxicillin
acute kidney injury
cohort study
crystalluria
incidence
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
26
11
2021
revised:
17
02
2022
accepted:
18
02
2022
entrez:
17
3
2022
pubmed:
18
3
2022
medline:
18
3
2022
Statut:
epublish
Résumé
Amoxicillin crystalluria (AC), potentially responsible for acute kidney injury (AKI), is reported more and more frequently in patients treated with high doses of intravenous amoxicillin (HDIVA). The main objective of this study was to evaluate AC incidence in these patients. The secondary objectives were to identify factors associated with AC and to evaluate its impact on the risk of AKI. This multicentre, observational, cohort study was conducted between Mar 18, 2014 and Aug 16, 2019 in Dijon, Nancy, and Reims University Hospitals as well as Châlon-sur-Saône, Charleville-Mézières, and Troyes general hospitals in France. Adult patients (≥18 years) treated with HDIVA and having been tested for AC at least once during treatment were included. Clinical, biological, and therapeutic characteristics of the patients were collected. A univariable mixed logistic regression model assessed the factors associated with AC. A multivariable Cox model with AC as a time-dependent variable assessed the prognostic factors for AKI. ClinicalTrials.gov number: NCT02853292. Of the 112 included patients, 27 (24.1%, 95% CI [16.2-32.0]) developed at least one episode of AC within a mean of 5.1 days. The factors associated with its occurrence were the concomitant use of angiotensin converting enzyme (ACE) inhibitors (OR=4.6, 95% CI [2.2-9.3], p<0.0001) and the decrease of urinary pH (OR=2.1 for one pH point decrease, 95% CI [1.2-3.7], p=0.009). 20 patients (17.9%) presented with AKI, within a mean time of 10.9 days. The main factor associated with the occurrence of AKI was the occurrence of AC (aHR=7.4, 95% CI [2.5-22.2], p=0.0003). AC occurred in a quarter of patients treated with HDIVA and was highly prognostic of AKI. None.
Sections du résumé
Background
UNASSIGNED
Amoxicillin crystalluria (AC), potentially responsible for acute kidney injury (AKI), is reported more and more frequently in patients treated with high doses of intravenous amoxicillin (HDIVA). The main objective of this study was to evaluate AC incidence in these patients. The secondary objectives were to identify factors associated with AC and to evaluate its impact on the risk of AKI.
Methods
UNASSIGNED
This multicentre, observational, cohort study was conducted between Mar 18, 2014 and Aug 16, 2019 in Dijon, Nancy, and Reims University Hospitals as well as Châlon-sur-Saône, Charleville-Mézières, and Troyes general hospitals in France. Adult patients (≥18 years) treated with HDIVA and having been tested for AC at least once during treatment were included. Clinical, biological, and therapeutic characteristics of the patients were collected. A univariable mixed logistic regression model assessed the factors associated with AC. A multivariable Cox model with AC as a time-dependent variable assessed the prognostic factors for AKI. ClinicalTrials.gov number: NCT02853292.
Findings
UNASSIGNED
Of the 112 included patients, 27 (24.1%, 95% CI [16.2-32.0]) developed at least one episode of AC within a mean of 5.1 days. The factors associated with its occurrence were the concomitant use of angiotensin converting enzyme (ACE) inhibitors (OR=4.6, 95% CI [2.2-9.3], p<0.0001) and the decrease of urinary pH (OR=2.1 for one pH point decrease, 95% CI [1.2-3.7], p=0.009). 20 patients (17.9%) presented with AKI, within a mean time of 10.9 days. The main factor associated with the occurrence of AKI was the occurrence of AC (aHR=7.4, 95% CI [2.5-22.2], p=0.0003).
Interpretation
UNASSIGNED
AC occurred in a quarter of patients treated with HDIVA and was highly prognostic of AKI.
Funding
UNASSIGNED
None.
Identifiants
pubmed: 35295665
doi: 10.1016/j.eclinm.2022.101340
pii: S2589-5370(22)00070-0
pmc: PMC8919213
doi:
Banques de données
ClinicalTrials.gov
['NCT02853292']
Types de publication
Journal Article
Langues
eng
Pagination
101340Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
We declare no competing interests.
Références
Eur J Case Rep Intern Med. 2017 Oct 23;4(10):000736
pubmed: 30755915
Nephrol Dial Transplant. 2003 Aug;18(8):1660-2
pubmed: 12897111
Br J Clin Pharmacol. 2020 Nov;86(11):2256-2265
pubmed: 32353167
J Clin Med. 2020 Jun 27;9(7):
pubmed: 32605085
Neth J Med. 2012 Mar;70(2):84, 87
pubmed: 22418755
Kidney Int. 2004 Apr;65(4):1422-5
pubmed: 15086484
Clin Pediatr (Phila). 1993 Dec;32(12):735-9
pubmed: 8275607
J Toxicol Clin Toxicol. 1986;24(2):175-82
pubmed: 3712526
Clin Nephrol. 1985 Jun;23(6):318-9
pubmed: 4028531
J Nephrol. 2021 Nov 11;:
pubmed: 34762277
Kidney Int. 2014 Nov;86(5):1065-6
pubmed: 25360508
Clin Nephrol. 2003 Jun;59(6):455-7
pubmed: 12834178
Antimicrob Agents Chemother. 2016 Apr 22;60(5):3248
pubmed: 26926627
Kidney Int Rep. 2020 Dec 13;6(3):830-834
pubmed: 33732998
Pediatr Infect Dis J. 1995 Oct;14(10):917-9
pubmed: 8584329
Lancet. 2015 Jun 6;385(9984):2296
pubmed: 25680270
Br J Clin Pharmacol. 1985 Feb;19(2):191-201
pubmed: 3986077
Nephrol Ther. 2015 Jun;11(3):174-90
pubmed: 25934324
West J Med. 1989 Jun;150(6):698-9
pubmed: 2750161
Nephrol Dial Transplant. 2021 Sep 27;36(10):1955-1958
pubmed: 33848352
Ann Biol Clin (Paris). 1990;48(5):331-2
pubmed: 2368939
Eur Heart J. 2021 Sep 21;42(36):3599-3726
pubmed: 34447992
Nephrol Dial Transplant. 2003 Jan;18(1):212-4
pubmed: 12480988
Intensive Care Med. 2020 Aug;46(8):1616-1617
pubmed: 32095849
Clin Pediatr (Phila). 2020 Jun;59(6):614-617
pubmed: 32233648