Concomitant Use of Multiple Nephrotoxins including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity: Combined Retrospective Analyses of Two Real-World Databases.
electronic medical records
nephrotoxin
polypharmacy
spontaneous adverse event reporting database
vancomycin-associated nephrotoxicity
Journal
Acta medica Okayama
ISSN: 0386-300X
Titre abrégé: Acta Med Okayama
Pays: Japan
ID NLM: 0417611
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
medline:
26
12
2023
pubmed:
26
12
2023
entrez:
25
12
2023
Statut:
ppublish
Résumé
There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + ≥2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
595-605Déclaration de conflit d'intérêts
No potential conflict of interest relevant to this article was reported.
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