| アブストラクト | There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + >/=2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN. |
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| ジャーナル名 | Acta medica Okayama |
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| 投稿日 | 2023/12/26 |
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| 投稿者 | Bando, Takashi; Chuma, Masayuki; Hamano, Hirofumi; Niimura, Takahiro; Okada, Naoto; Kondo, Masateru; Izumi, Yuki; Ishida, Shunsuke; Yoshioka, Toshihiko; Asada, Mizuho; Zamami, Yoshito; Takechi, Kenshi; Goda, Mitsuhiro; Miyata, Koji; Yagi, Kenta; Izawa-Ishizaka, Yuki; Azuma, Momoyo; Yanagawa, Hiroaki; Tasaki, Yoshikazu; Ishizawa, Keisuke |
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| 組織名 | Department of Pharmacy, Tokushima University Hospital.;Department of Clinical Pharmacology and Therapeutics, Tokushima University;Graduate School of Biomedical Sciences.;Clinical Research Center for Developmental Therapeutics, Tokushima University;Hospital.;Department of Hospital Pharmacy and Pharmacology, Asahikawa Medical University.;Department of Pharmacy, Okayama University Hospital.;Department of Medical Molecular Informatics, Meiji Pharmaceutical University.;Department of Drug Information Analysis, College of Pharmaceutical Sciences,;Matsuyama University.;Department of Pharmacology, Tokushima University Graduate School of Biomedical;Sciences.;Department of Infection Control and Prevention, Tokushima University Hospital.;Department of Nursing, Faculty of Health and Welfare, Tokushima Bunri University. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38145933/ |
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