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ID 118742
Title Alternative
腎血流量を低下させる薬剤を含む複数の腎毒性を有する薬の併用はバンコマイシン関連腎障害を引き起こす : 2つのリアルワールドデータベースを組み合わせた後方視的研究
Nephrotoxicity with VCM and Nephrotoxins
Author
Bando, Takashi Tokushima University
Chuma, Masayuki Tokushima University|Asahikawa Medical University
Kondo, Masateru Tokushima University
Izumi, Yuki Tokushima University
Ishida, Shunsuke Tokushima University
Yoshioka, Toshihiko Tokushima University
Asada, Mizuho Meiji Pharmaceutical University
Takechi, Kenshi Matsuyama University
Miyata, Koji Tokushima University
Tasaki, Yoshikazu Asahikawa Medical University
Keywords
vancomycin-associated nephrotoxicity
polypharmacy
nephrotoxin
spontaneous adverse event reporting database
electronic medical records
Content Type
Thesis or Dissertation
Description
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.
Journal Title
Acta Medica Okayama
ISSN
0386300X
NCID
AA00508441
Publisher
Okayama University Medical School
Volume
77
Issue
6
Start Page
595
End Page
605
Published Date
2023-12
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Takashi Bandoの学位論文として提出され,学位審査・授与の対象となっている。
利用は著作権の範囲内に限られる。
Rights
CopyrightⒸ 2023 by Okayama University Medical School
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3761号
Diploma Number
甲医第1586号
Granted Date
2023-10-26
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences
Pharmaceutical Sciences