Authors | Concomitant nephrotoxic agent | Outcome definition | Comparable outcome | High trough group, n (%) | Low trough group, n (%) | p valuea | Crude OR (95% CI) | Adjusted OR (95% CI) |
---|---|---|---|---|---|---|---|---|
NA | Mortality: 30-day all-cause mortality |  | n = 61 | n = 67 |  |  |  | |
Mortality | 12 (19.7) | 14 (20.9) | 0.962 | 0.93 (0.39–2.20) | NA | |||
Clinical success: (1) resolution of bacteremia in ≤7 days of VAN therapy; (2) resolution of signs and symptoms; (3) required no change of antibiotics; and, (4) non-recurrence of BSI or survived for at least 30 days |  | n = 34 | n = 75 |  |  |  | ||
Clinical success | 15 (44.1) | 30 (40) | 0.846 | 1.18 (0.52–2.69) | NA | |||
Zelenitsky et al. [67] | NA | Mortality: 30-day all-cause mortality from the date of the first positive blood culture |  | n = 17 | n = 18 |  |  |  |
Mortality | 5 (29.4) | 13 (72.2) | 0.028 | 0.16 (0.04–0.69) | NA | |||
Tadros et al. [68] | NA | Mortality: 30-day all-cause mortality |  | n = 41 | n = 56 |  |  |  |
Mortality | 10 (24.4) | 11 (19.6) | 0.756 | 1.32 (0.50–3.48) | NA | |||
Arshad et al. [69] | NA | Mortality: Death within 30 days |  | n = 49 | n = 55 |  |  |  |
Mortality | 7 (14.3) | 3 (5.5) | 0.185 | 2.89 (0.70–11.86) | NA | |||
Nephrotoxicity: Increase in SCr of 0.5 mg/dL or ≥50 % increase from initiation of VAN to 3 days for at least 2 consecutive measurements | Nephrotoxicity | 13 (26.5) | 5 (9.1) | 0.037 | 3.61 (1.18–11.03) |  | ||
Clinical success: (1) survived for at least 30 days; (2) without recurrence of MRSA infection at least 30 days; and/or, (3) negative blood culture at least 6 days | Clinical success | 40 (81.6) | 48 (87.3) | 0.601 | 0.65 (0.22–1.90) |  | ||
Leu et al. [34] | Not stated | Nephrotoxicity: Increase in SCr of 0.5 mg/d3L or decrease in CrCl >50 % from baseline |  | n = 45 | n = 31 |  |  |  |
Nephrotoxicity | 10 (22.2) | 5 (16.1) | 0.717 | 1.49 (0.45–4.87) | NA | |||
Clinical cure: All signs and symptoms of infection were resolved after discontinuation of VAN | Clinical cure | 11 (24.4) | 12 (38.7) | 0.282 | 0.51 (0.19–1.38) | NA | ||
Kullar et al. [17] | Aminoglycoside, colistin, acyclovir | Mortality: 30-day all-cause mortality |  | n = 100 | n = 100 |  |  |  |
Mortality | 13 (13.0) | 8 (8.0) | 0.356 | 1.72 (0.68–4.35) | NA | |||
Nephrotoxicity: increase in SCr concentrations of 0.5 mg/dL or ≥50% increase from baseline for at least 2–3 consecutive measurements | Nephrotoxicity | 18 (18.0) | 15 (15.0) | 0.703 | 1.24 (0.59–2.63) | NA | ||
Clinical success: (1) Survived for at least 30 days; (2) resolution of signs and symptoms of MRSAB at the end of VAN therapy; or, (3) eradication of MRSAB after at least 7 days of VAN therapy | Clinical success | 60 (60.0) | 45 (45.0) | 0.047 | 1.83 (1.05–3.21) | NA | ||
Rojas et al. [38] | Not stated | Mortality: overall mortality |  | n = 24 | n = 61 |  |  |  |
Mortality | 8 (33.3) | 22 (36.1) | 0.988 | 0.89 (0.33–2.40) | NA | |||
Wunderink et al. [70] | Not stated | Nephrotoxicity: increase in SCr of 0.5 mg/dL if normal at baseline or 50% increase in SCr if abnormal at baseline |  | n = 118 | n = 215 |  |  |  |
Nephrotoxicity | 26 (22.0) | 24 (11.2) | 0.013 | 2.25 (1.22–4.13) | NA | |||
Bosso et al. [71] | Aminoglycoside, cyclosporine A, tacrolimus, nonsteroidal inflammatory agents, COX-2 inhibitors, ACEIs, ARB | Nephrotoxicity: increase in SCr of 0.5 mg/dL or increase ≥50% in SCr from baseline for two consecutive measurements |  | n = 142 | n = 146 |  |  | n = 280 |
Nephrotoxicity | 41 (28.9) | 14 (9.6) | <0.001 | 3.83 (1.98–7.40) | 3.64 (1.75–7.59)b | |||
Chan et al. [72] | Not stated | Mortality: all cause mortality at hospital discharge |  | n = 33 | n = 39 |  |  |  |
Mortality | 5 (15.2) | 6 (15.4) | 0.763 | 0.98 (0.27–3.57) | NA | |||
Clinical cure: improvement in and resolution of signs and symptoms of VAP, and eradication of MRSA from subsequent BAL or sputum culture after completing ≥7 days of VAN therapy together with CPIS <6 at day 7 of therapy | Clinical cure | 24 (72.7) | 27 (69.2) | 0.948 | 1.19 (0.43–3.30) | NA | ||
Choi et al. [13] | NA | Nephrotoxicity: increase in SCr of 0.5 mg/dL or increase ≥50 % in SCr from baseline |  | n = 19 | n = 37 |  |  |  |
Nephrotoxicity | 2 (10.5) | 3 (8.1) | 1.000 | 1.33 (0.20–8.75) | NA | |||
Chung et al. [36] | Not stated | Mortality: overall ICU mortality |  | n = 16 | n = 38 |  |  |  |
ICU mortality | 7 (43.8) | 17 (44.7) | 0.816 | 0.96 (0.30–3.12) | NA | |||
Clinical success: resolution of baseline signs and symptoms of MRSA pneumonia in conjunction with improvement in or lack of progression of chest radiographic abnormalities | Clinical success | 8 (50.0) | 15 (39.5) | 0.680 | 1.53 (0.47–4.97) | NA | ||
Clemend et al. [37] | Not stated | Mortality: 30-day all-cause mortality |  | n = 68 | n = 26 |  |  |  |
Mortality | 7 (10.3) | 4 (15.4) | 0.490 | 0.63 (0.17–2.37) | 0.18 (0.03–1.12)c | |||
Clinical success: (1) survived for at least 30 days; (2) eradication of MRSAB within 10 days from the initiation of VAN therapy; or, (3) absence of MRSAB for at least 30 days after discontinuation of therapy | Clinical success | 50 (73.5) | 21 (80.8) | 0.467 | 0.66 (0.22–2.02) | 1.10 (0.26–4.76)c | ||
Honda et al. [73] | Not stated | Mortality: any death within 28 days of initial hospital stay; or, if there were no readmission data >28 days after diagnosis of MRSAB available, SSDI was used to verify mortality |  | n = 64 | n = 87 |  |  |  |
Mortality | 13 (20.3) | 14 (16.1) | 0.650 | 1.33 (0.58–3.06) | NA | |||
Kullar et al. [33] | Aminoglycosides | Nephrotoxicity: increase in SCr of 0.5 mg/dL or ≥50 % increase in SCr from baseline for 2 consecutive measurements |  | n = 77 | n = 141 |  |  |  |
Nephrotoxicity | 10 (13.0) | 23 (16.3) | 0.648 | 0.77 (0.34–1.71) | NA | |||
Clinical success: surviving for at least 30 days, resolution of signs and symptoms of infection at the end of therapy, or absence of MRSAB for at least 7 days of VAN therapy |  | n = 86 | n = 160 |  |  |  | ||
Clinical success | 52 (60.5) | 62 (38.8) | 0.002 | 2.42 (1.41–4.13) | NA | |||
Hermsen et al. [35] | NSAIDs, aminoglycosides (n = 12), amphotericin B (n = 55), cisplatin, pentamidine, ribavirin, ACE inhibitors, angiotensin receptor blockers, and diuretics | Nephrotoxicity: increase in SCr of 0.5 mg/dL or increase ≥50 % in SCr from baseline for at least 2 consecutive measurements |  | n = 16 | n = 39 |  |  |  |
Nephrotoxicity | Â | Â | Â | Â | Â | |||
Definition 1 or 2 | 5 (31.3) | 4 (10.3) | 0.103 | 3.98 (0.91–17.46) | 3.27 (0.70–15.25)d | |||
Definition 3 | 4 (25.0) | 5(12.8) | 0.422 | 2.27 (0.52–9.86) | NA | |||
Mortality: in-hospital mortality | Mortality | 3 (18.8) | 2 (5.1) | 0.141 | 4.27 (0.64–28.47) | NA | ||
Clinical success: resolution of signs and symptoms of infection and no additional use of antibiotics or eradication of MRSA, defined as negative culture result at the end of VAN therapy | Clinical success | 4 (25.0) | 21 (53.8) | 0.098 | 0.29 (0.08–1.04) | NA | ||
Jeffres et al. [31] | IV contrast dye (n = 24), loop diuretic (n = 49), amphotericin B (n = 5), aminoglycoside (n = 8), ACE-I or ARB (n = 19), cyclosporine or tacrolimus (n = 9), vasopressor (n = 14) | Nephrotoxicity: increase in SCr of 0.5 mg/dL or increase in SCr ≥50 % from baseline for two consecutive measurements |  | n = 49 | n = 45 |  |  |  |
Nephrotoxicity | 27 (55.1) | 13 (28.9) | 0.018 | 3.02 (1.28–7.11) | 2.82 (1.02–7.74)e | |||
Hidayat et al. [30] | Amphotericin B, tobramycin, and tacrolimus (n = 27) | Nephrotoxicity: Increase in SCr of 0.5 mg/dL or increase ≥50 % in SCr from baseline for 2 consecutive measurements |  | n = 63 | n = 32 |  |  |  |
Nephrotoxicity | 11 (17.5) | 0 (0) | 0.014 | NA | NA |