Antimicrobial therapy with aminoglycoside or meropenem in the intensive care unit for hospital associated infections and risk factors for acute kidney injury.
There have historically been concerns of acute kidney injury (AKI) with the use of aminoglycosides. The present study aimed to compare the AKI incidence and mortality rate between critically ill patients treated with aminoglycoside or meropenem in the intensive care unit setting using a propensity score matching approach. This cross-sectional study was conducted at two university hospitals from January 2011 to October 2017. Clinical and laboratorial data were evaluated to exclude potential confounders and to calculate the Charlson index. AKI was classified according to the Acute Kidney Injury Network criteria. All tests were two-tailed, and a p value ≤ 0.05 was considered significant in the univariate and multivariate analyses. We included 494 patients, 95 and 399 of whom used meropenem and aminoglycoside, respectively. Patients in the subgroup that used meropenem were matched with controls (aminoglycoside). Among the 494 patients, 120 developed any grade of AKI (24.2%). After propensity score matching, there were no significant differences in AKI incidence and mortality rate between the aminoglycoside and meropenem groups (p = 0.324 and 0.464, respectively). Patients on the aminoglycoside regimen neither presented a higher AKI incidence nor mortality rate when compared with those on the meropenem regimen. Aminoglycosides may be a safe option for the treatment of critically ill patients on carbapenem sparing antimicrobial stewardship programs.
['Pitta|Raphael Donadio|RD|', 'Gasparetto|Juliano|J|', 'De Moraes|Thyago Proença|TP|', 'Telles|João Paulo|JP|', 'Tuon|Felipe Francisco|FF|http://orcid.org/0000-0003-3471-1786']
D058186:Acute Kidney Injury D000368:Aged D000617:Aminoglycosides D000900:Anti-Bacterial Agents D016638:Critical Illness D003428:Cross Infection D003430:Cross-Sectional Studies D005260:Female D006785:Hospitals, University D006801:Humans D015994:Incidence D007362:Intensive Care Units D008297:Male D000077731:Meropenem D008875:Middle Aged D057216:Propensity Score D012189:Retrospective Studies D012307:Risk Factors
Aminoglycoside Meropenem Acute kidney injury Amikacin Gentamicin Renal failure