Table 1.
Baseline Patient Demographic and Clinical Characteristics
| Description | PTZ/VAN (n = 1540) |
CEF/VAN (n = 1373) |
MER/VAN (n = 386) |
P Value |
|---|---|---|---|---|
| Age, mean (SD), y | 64 (17) | 63 (17) | 64 (17) | .18 |
| Male sex, No. (%) | 943 (61) | 801 (58) | 212 (55) | .050 |
| White race, No. (%) | 1405 (91) | 1240 (90) | 351 (91) | .69 |
| Height, mean (SD), cm | 170 (11) | 170 (11) | 169 (11) | .02 |
| Weight, mean (SD), kg | 85 (26) | 84 (24) | 83 (27) | .20 |
| Body mass index, mean (SD), kg/m2 | 29 (8) | 29 (7) | 29 (8) | .65 |
| APACHE III score, mean (SD) | 67 (22) | 64 (23) | 72 (25) | <.001 |
| SOFA score, mean (SD), | 5.2 (3.1) | 4.8 (3.1) | 5.8 (3.3) | <.001 |
| Charlson Comorbidity Index, mean (SD) | 5.9 (3.7) | 5.8 (3.7) | 6.1 (3.6) | .26 |
| Vasopressor use, No. (%) | 664 (43) | 540 (39) | 172 (45) | .057 |
| Lactate, mean (SD), mmol/La | 1.9 (1.6) | 1.9 (1.4) | 1.8 (1.2) | .16 |
| Baseline serum creatinine, median (IQR), mg/dL | 1.0 (0.8– 1.3) | 1.0 (0.8–1.3) | 1.0 (0.7– 1.4) | .61 |
| Renal parameters at antibiotic initiation | ||||
| Serum creatinine, mean (SD), mg/dL | 1.1 (0.5) | 1.0 (0.5) | 1.0 (0.5) | <.001 |
| Creatinine clearance, mean (SD), mL/min | 64.0 (39.4) | 67.6 (37.6) | 66.2 (39.1) | .003 |
| AKI stage 1 at antibiotic initiation, No. (%) | 457 (30) | 315 (23) | 108 (28) | <.001 |
| AKI risk prediction score at antibiotic initiation, No. (%) of each component)b | 6.0 (3.0) | 5.8 (3.2) | 6.5 (3.2) | <.001 |
| Chronic kidney disease | 205 (13) | 171 (13) | 59 (13) | .79 |
| Chronic liver disease | 32 (2) | 20 (2) | 9 (2) | .35 |
| Congestive heart failure | 216 (14) | 184 (13) | 54 (14) | .88 |
| Hypertension | 871 (57) | 697 (51) | 201 (52) | .006 |
| Atherosclerotic cardiovascular disease | 433 (28) | 373 (27) | 118 (31) | .42 |
| pH ≤7.3 | 286 (19) | 279 (20) | 107 (28) | <.001 |
| Mechanical ventilation | 830 (54) | 726 (53) | 217 (56) | .50 |
| Anemia (hemoglobin <9 g/dL) | 681 (44) | 588 (43) | 194 (50) | .03 |
| Sepsis | 1132 (74) | 910 (66) | 299 (78) | <.001 |
| Nephrotoxin exposure, No. (%)c | ||||
| Amphotericin B | 4 (0) | 4 (0) | 5 (1) | .03 |
| Aminoglycosides | 8 (1) | 13 (1) | 5 (1) | .21 |
| Iodinated contrast | 14 (1) | 2 (0) | 1 (0) | .01 |
| Chemotherapy (nephrotoxic) | 3 (0) | 3 (0) | 1 (0) | >.99 |
| Antiretroviral medications | 0 (0) | 3 (0) | 1 (0) | .13 |
| Culture-positive infection, No. (%) | 468 (30) | 351 (26) | 127 (33) | .002 |
| VAN dosage, mean (SD) | ||||
| Dosage, mg/d | 2125 (797) | 2181 (829) | 2017 (801) | .002 |
| Dosage, mg/kg/d | 25.4 (7.7) | 26.2 (8.1) | 24.8 (7.5) | .001 |
Abbreviations: AKI, acute kidney injury; APACHE, Acute Physiology and Chronic Health Evaluation; CEF, cefepime; IQR, interquartile range; MER, meropenem; PTZ, piperacillin-tazobactam; SD, standard deviation; SOFA, Sequential Organ Failure Assessment; VAN, vancomycin.
aValue not obtained during intensive care unit stay for 32% of patients.
bThis score assigns points for increasing risk related to chronic conditions (chronic kidney disease, chronic liver disease, congestive heart failure, hypertension, atherosclerotic cardiovascular disease) and acute disease states and exposures (pH ≤7.3, nephrotoxin exposure, sepsis [defined according to Sepsis-3 criteria], mechanical ventilation requirement, and anemia) [23, 24]. Scores range from 0 to 21, with higher scores indicating increased risk.
cNephrotoxin exposure was evaluated from 7 days before hospital admission to 48 hours after intensive care unit admission.