Combination of vancomycin plus piperacillin and risk of acute kidney injury: a worldwide pharmacovigilance database analysis

Abstract Background Excess of acute kidney injury (AKI) secondary to the association vancomycin plus piperacillin is debated. Objectives To detect a signal for an increased risk AKI with and combination compared other vancomycin-based regimens. Methods Using VigiBase, WHO global database individual case safety reports (ICSR) from 1997 2019, we conducted disproportionality analysis comparing reporting cases between different regimens (vancomycin piperacillin, cefepime or meropenem). take into account possible notoriety bias, secondarily restricted study period before 2014, date first publication in patients receiving piperacillin. Results are expressed using OR (ROR) its 95% CI. From 53 701 ICSR concerning have been registered database, including 6016 (11.2%), among which 925 (15.4%) were reported vancomycin/piperacillin, 339 (5.6%) vancomycin/cefepime 197 (3.7%) vancomycin/meropenem. ROR (95% CI) was 2.6 (2.4–2.8) 2.5 (2.2–2.9) 0.5 (0.4–0.6) vancomycin/meropenem versus vancomycin-containing After restriction 1997–2013, remains significant only vancomycin/piperacillin [ROR = 2.1 (1.8–2.4)]. Conclusions We found This suggests drug–drug interaction these two antibiotics resulting AKI.