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High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy

High-dose amoxicillin and cloxacillin combination therapy is recommended for the empiric treatment of selected patients with infective endocarditis despite a low level of evidence. The main objective of this study was to evaluate the renal tolerance of high-dose intravenous amoxicillin and cloxacill...

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Autores principales: Ruch, Yvon, Ursenbach, Axel, Danion, François, Reisz, Fanny, Nai, Thierry, Hoellinger, Baptiste, Hansmann, Yves, Lefebvre, Nicolas, Martzloff, Jonas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220067/
https://www.ncbi.nlm.nih.gov/pubmed/35740176
http://dx.doi.org/10.3390/antibiotics11060770
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author Ruch, Yvon
Ursenbach, Axel
Danion, François
Reisz, Fanny
Nai, Thierry
Hoellinger, Baptiste
Hansmann, Yves
Lefebvre, Nicolas
Martzloff, Jonas
author_facet Ruch, Yvon
Ursenbach, Axel
Danion, François
Reisz, Fanny
Nai, Thierry
Hoellinger, Baptiste
Hansmann, Yves
Lefebvre, Nicolas
Martzloff, Jonas
author_sort Ruch, Yvon
collection PubMed
description High-dose amoxicillin and cloxacillin combination therapy is recommended for the empiric treatment of selected patients with infective endocarditis despite a low level of evidence. The main objective of this study was to evaluate the renal tolerance of high-dose intravenous amoxicillin and cloxacillin combination. We studied 27 patients treated with amoxicillin and cloxacillin (≥100 mg/kg daily) for at least 48 h. The primary endpoint was the occurrence of acute kidney injury (AKI). The median patient age was 68 ± 8 years, and 16 (59%) were male. The indication for this combination therapy was suspected or confirmed endocarditis with no bacterial identification in 22 (81%) patients. The primary endpoint occurred in 16 (59%) patients after initiating this combination therapy within an average of 4.4 ± 3.6 days. Among them, seven (26%) patients developed severe AKI, including four (15%) patients who required hemodialysis. Other risk factors for AKI were identified in all patients, including injection of iodinated contrast media in 21 (78%), acute heart failure in 18 (67%), cardiac surgery in 11 (41%), and aminoglycoside use in 9 (33%) patients. This study reports an incidence of 59% of AKI after initiating amoxicillin and cloxacillin combination therapy in a population at high renal risk.
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spelling pubmed-92200672022-06-24 High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy Ruch, Yvon Ursenbach, Axel Danion, François Reisz, Fanny Nai, Thierry Hoellinger, Baptiste Hansmann, Yves Lefebvre, Nicolas Martzloff, Jonas Antibiotics (Basel) Article High-dose amoxicillin and cloxacillin combination therapy is recommended for the empiric treatment of selected patients with infective endocarditis despite a low level of evidence. The main objective of this study was to evaluate the renal tolerance of high-dose intravenous amoxicillin and cloxacillin combination. We studied 27 patients treated with amoxicillin and cloxacillin (≥100 mg/kg daily) for at least 48 h. The primary endpoint was the occurrence of acute kidney injury (AKI). The median patient age was 68 ± 8 years, and 16 (59%) were male. The indication for this combination therapy was suspected or confirmed endocarditis with no bacterial identification in 22 (81%) patients. The primary endpoint occurred in 16 (59%) patients after initiating this combination therapy within an average of 4.4 ± 3.6 days. Among them, seven (26%) patients developed severe AKI, including four (15%) patients who required hemodialysis. Other risk factors for AKI were identified in all patients, including injection of iodinated contrast media in 21 (78%), acute heart failure in 18 (67%), cardiac surgery in 11 (41%), and aminoglycoside use in 9 (33%) patients. This study reports an incidence of 59% of AKI after initiating amoxicillin and cloxacillin combination therapy in a population at high renal risk. MDPI 2022-06-04 /pmc/articles/PMC9220067/ /pubmed/35740176 http://dx.doi.org/10.3390/antibiotics11060770 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ruch, Yvon
Ursenbach, Axel
Danion, François
Reisz, Fanny
Nai, Thierry
Hoellinger, Baptiste
Hansmann, Yves
Lefebvre, Nicolas
Martzloff, Jonas
High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy
title High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy
title_full High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy
title_fullStr High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy
title_full_unstemmed High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy
title_short High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy
title_sort high incidence of acute kidney injury in patients treated with high-dose amoxicillin and cloxacillin combination therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220067/
https://www.ncbi.nlm.nih.gov/pubmed/35740176
http://dx.doi.org/10.3390/antibiotics11060770
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