ID | 66151 |
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Author |
Bando, Takashi
Department of Pharmacy, Tokushima University Hospital
Chuma, Masayuki
Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
Hamano, Hirofumi
Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences
Niimura, Takahiro
Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
Okada, Naoto
Department of Pharmacy, Tokushima University Hospital
Kondo, Masateru
Department of Pharmacy, Tokushima University Hospital
Izumi, Yuki
Department of Pharmacy, Tokushima University Hospital
Ishida, Shunsuke
Department of Pharmacy, Tokushima University Hospital
Yoshioka, Toshihiko
Department of Pharmacy, Tokushima University Hospital
Asada, Mizuho
Department of Medical Molecular Informatics, Meiji Pharmaceutical University
Zamami, Yoshito
Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences
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Takechi, Kenshi
Department of Drug Information Analysis, College of Pharmaceutical Sciences, Matsuyama University
Goda, Mitsuhiro
Department of Pharmacy, Tokushima University Hospital
Miyata, Koji
Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences
Yagi, Kenta
Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
Izawa-Ishizawa, Yuki
Department of Pharmacology, Tokushima University Graduate School of Biomedical Sciences
Azuma, Momoyo
Department of Infection Control and Prevention, Tokushima University Hospital
Yanagawa, Hiroaki
Department of Nursing, Faculty of Health and Welfare, Tokushima Bunri University
Tasaki, Yoshikazu
Department of Hospital Pharmacy and Pharmacology, Asahikawa Medical University
Ishizawa, Keisuke
Department of Pharmacy, Tokushima University Hospital
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Abstract | 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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Keywords | vancomycin-associated nephrotoxicity
polypharmacy
nephrotoxin
spontaneous adverse event reporting database
electronic medical records
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Amo Type | Original Article
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Publication Title |
Acta Medica Okayama
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Published Date | 2023-12
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Volume | volume77
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Issue | issue6
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Publisher | Okayama University Medical School
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Start Page | 595
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End Page | 605
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ISSN | 0386-300X
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NCID | AA00508441
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Content Type |
Journal Article
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language |
English
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Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School
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File Version | publisher
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Refereed |
True
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