Is the Combination of Piperacillin‐Tazobactam and Vancomycin Associated with Development of Acute Kidney Injury? A Meta‐analysis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Study Objective To evaluate the association of the development of acute kidney injury (AKI) when piperacillin‐tazobactam is used in combination with vancomycin compared with vancomycin with or without a β‐lactam. Design Meta‐analysis of 15 observational cohort studies. Patients A total of 3258 adult inpatients who received vancomycin + piperacillin‐tazobactam versus vancomycin alone (10 studies); vancomycin + piperacillin‐tazobactam versus vancomycin + β‐lactam (four studies); or vancomycin + piperacillin‐tazobactam versus vancomycin alone or vancomycin + other antibiotics (one study). Measurements and Main Results The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases, as well as meeting proceedings, were searched (1966–June 1, 2016). Quality of studies was assessed by using the Newcastle‐Ottawa Quality Assessment Scale (NOQAS). The primary outcome of this meta‐analysis was to evaluate the association of development of AKI with the combined use of piperacillin‐tazobactam and vancomycin. A subgroup analysis was also performed that examined the outcome by comparison groups (vancomycin alone or vancomycin + β‐lactam). Sensitivity analysis was performed to explore if the results differed based on removal of abstracts and removal of low‐quality studies (NOQAS scores of 6 or lower). All analyses were performed using the random effects model. NOQAS scores for the 15 studies ranged from 3–7 points (of a total of 9). Overall, there was an association with the development of AKI with vancomycin + piperacillin‐tazobactam compared with vancomycin ± β‐lactam (odds ratio [OR] 3.649, 95% confidence interval [CI] 2.157–6.174; I 2 = 83.5%, p<0.001). The association remained significant when abstracts were removed (OR 3.498, 95% CI 1.747–7.003, I 2 = 82.3%, p<0.001) and when low‐quality studies were removed (OR 4.596, 95% CI 2.929–7.212, I 2 = 0%, p<0.001). The association for the development of AKI with vancomycin + piperacillin‐tazobactam compared with vancomycin alone was significant (OR 3.980, 95% CI 2.749–5.763, I 2 = 31.4%, p<0.001), although the association did not remain significant for the vancomycin + β‐lactam subgroup (OR 3.029, 95% CI 0.942–9.738, I 2 = 82.3%, p=0.063). Conclusion Vancomycin + piperacillin‐tazobactam was associated with an increased risk of AKI compared with vancomycin ± β‐lactam. Practitioners need to be vigilant about this association when prescribing this combination of antibiotics.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it