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Nephrotoxicity comparison in two commercially available generic vancomycin products.
Antimicrob Agents Chemother. 2015 Jun 29;
Authors: Sutton JD, Mynatt RP, Kaye KS, Murray KP, Rybak MJ, Pogue JM
Abstract
To date, no comparative clinical studies have investigated the effect different vancomycin products may have on nephrotoxicity. The objective of this single center, retrospective, matched cohort study was to investigate the impact of two different vancomycin products on the development of nephrotoxicity. The study population included adults receiving a single vancomycin product, either Pfizer or Hospira, for their entire course of therapy. Patients were matched based on underlying nephrotoxicity risk factors. Secondary outcomes were need for renal replacement therapy, length of hospital stay, and in-hospital mortality. One-hundred forty-six matched pairs (N=292) were included with no significant differences in demographics, co-morbid conditions, severity of illness, and vancomycin-associated nephrotoxicity risk factors. The frequency of nephrotoxicity was 8.9% in the Pfizer group and 11.0% in the Hospira group as defined by the 2009 vancomycin guideline definition (p=0.56), was 17.1% in the Pfizer group and 13.0% in the Hospira group as defined by the AKIN definition (p=0.33), and was 10.3% in the Pfizer group and 11.6% in the Hospira group as defined by RIFLE criteria (p=0.71). There were no differences between groups with regard to nephrotoxicity by any definition or in secondary outcomes. In multivariate analysis of overall nephrotoxicity risk factors, the type of vancomycin product was not independently associated with increased odds of nephrotoxicity defined by RIFLE criteria. Based on our results, there are no discernable differences in the frequency of nephrotoxicity between Pfizer and Hospira vancomycin products. Confirmation of these results with other types of vancomycin and patients populations is warranted.
PMID: 26124161 [PubMed - as supplied by publisher]