Students Research in Progress
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Carbapenems are broad-spectrum antimicrobials used to treat patients with pneumonia, bacteremia, and/or sepsis at risk of, or due to, multidrug-resistant pathogens. Patients who require the use of a carbapenem may be at an increased risk of acute kidney injury (AKI). Cilastatin has several proposed nephroprotective mechanisms. These potential benefits may extend beyond its co-formulation with imipenem to minimize AKI due to imipenem’s toxic metabolites. However, clinical data comparing AKI rates of imipenem-cilastatin to another carbapenem limited to a single-center study that observed imipenem-cilastatin was associated with a decrease in AKI rates compared to meropenem.
Research Question or Hypothesis: Imipenem-cilastatin in patients with pneumonia, bacteremia, and/or sepsis will be associated with lower rates of AKI than meropenem.
Study Design: Retrospective cohort study
Methods: We will conduct a retrospective cohort study of inpatients treated with meropenem or imipenem-cilastatin who have an ICD-9 or ICD-10 code for pneumonia, bacteremia, and/or sepsis. The study will utilize patients meeting inclusion criteria from various hospitals across the United States who contributed data to be included in the Oracle EHR real-world database during the study timeframe (2015-2022). Patients with a baseline serum creatinine of 4.0 mg/dL or who are receiving dialysis at baseline will be excluded as these patients, by definition, cannot experience AKI. All data submitted to the Oracle EHR real-world database is de-identified, so IRB approval was not required. Data collection will include demographic data, Elixhauser comorbidity index and associated comorbidities, concomitant nephrotoxins, serum creatinine, and initiation of dialysis. The primary endpoint will be the incidence of AKI defined by a 50% increase in serum creatinine within seven days or an increase of 0.3 mg/dL within two days. We will utilize a Cox proportional hazards model to evaluate the primary endpoint. Covariates for the model will be chosen a priori by utilizing a conceptual model of AKI.
Results: N/A
Conclusion: N/A
Presenting Author
Hannah Gorczyca MBATexas Tech University Health Sciences Center School of Pharmacy
Authors
Carlos Alvarez Pharm.D., M.Sc., BCPS, MSCS
Texas Tech University Health Sciences Center
Ronald Hall II Pharm.D., MSCS
Texas Tech Health Sciences Center
Christine Vu MPH, CPH
Texas Tech University Health Sciences Center