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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Incidence and Risk Factors for Vancomycin Nephrotoxicity in Acutely Ill Pediatric Patients
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Incidence and Risk Factors for Vancomycin Nephrotoxicity in Acutely Ill Pediatric Patients

机译：急性病儿科患者的万古霉素肾毒性发生率和危险因素

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Background: Particularly with the current increased vancomycin dosing trends, the true risk of the agent’s nephrotoxicity is not well characterized and remains of concern. Objective: To determine the incidence of vancomycin nephrotoxicity in acutely ill hospitalized children and to secondarily characterize the risk factors for this complication. Methods: A single-center retrospective cohort study conducted at UCSF Benioff Children’s Hospital from June 2012 to June 2015. Inpatients 3 months to Results: A total of 291 patients (272 nonnephrotoxic and 19 nephrotoxic) were included in the analysis. Of the 19 patients, 12 (4.1%) were found to have moderate to severe toxicity. The median duration of therapy was 3 (3-5) and 4 (3-6) days for the group with “no nephrotoxicity” and “nephrotoxicity,” respectively. The mean time for the serum creatinine to return to normal in patients with nephrotoxicity was 5.1 days. In the multivariate analysis, only final trough concentration ≥15mg/dL (odds ratio = 3.49, 95% confidence interval = 1.2-10.1; P = .021) and receipt of piperacillin/tazobactam (odds ratio = 3.14, 95% confidence interval = 1.02-9.6; P = .046) were significantly associated with nephrotoxicity. Conclusion: The rate of moderate to severe vancomycin-associated nephrotoxicity in acutely ill children is relatively uncommon and reversible. Kidney injury is associated with increased vancomycin trough concentrations and concomitant receipt of nephrotoxins, particularly piperacillin/tazobactam.
机译：背景：特别是随着当前的万古霉素给药趋势增加，代理人的肾毒性的真正风险并不具备很好的特征和遗骸。目的：确定急性病住院儿童的万古霉素肾毒性的发病率，并分析表征这种并发症的危险因素。方法：2012年6月至2015年6月，在UCSF Benioff儿童医院进行单中心回顾队列研究。进入结果3个月：共有291名患者（272名非毒性毒性和19个肾毒性）分析。在19名患者中，发现12名（4.1％）具有中度至严重的毒性。该组分别为“无肾毒性”和“肾毒性”分别为3（3-5）和4（3-6）天，分别为3（3-5）和4（3-6）天。血清肌酐在肾毒性患者中恢复正常的平均时间为5.1天。在多变量分析中，仅最终槽浓度≥15mg/ dl（差距= 3.49,95％置信区间= 1.2-10.1; p = .021），并收到哌啶/塔扎酰胺（差距= 3.14,95％置信区间= 1.02-9.6; p = .046）与肾毒性显着相关。结论：急剧生病儿童中度至严重的万古霉素相关肾毒性的速率相对罕见和可逆。肾脏损伤与增加的万古霉素槽浓度增加以及伴随收到肾毒素，特别是哌啶/塔沙漠酰胺。

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