Risk Factors for Nephrotoxicity in Methicillin-Resistant Staphylococcus aureus Bacteraemia: A Post Hoc Analysis of the CAMERA2 Trial

• DOI: 10.1007/s40261-022-01204-z
• Publication Date: 2022-10-10T17:02:46Z
• Authors: Amy Legg; Niamh Meagher; Sandra A. Johnson; Matthew A. Roberts; Alan Cass; Marc H. Scheetz; Jane Davies; Jason A. Roberts; Joshua S. Davis; Steven Y. C. Tong
• Keywords: Cloxacillin; Nephrotoxicity; Post-hoc analysis; Renal replacement therapy

Clinical risk factors for nephrotoxicity in Staphylococcus aureus bacteraemia remain largely undetermined, despite its common occurrence and clinical significance. In an international, multicentre, prospective trial (CAMERA2), which compared standard therapy (vancomycin monotherapy) to combination (adding anti-staphylococcal beta-lactam) methicillin-resistant S. bacteraemia, significantly more people the arm experienced acute kidney injury with those monotherapy (23% vs 6%).The aim of this post hoc analysis was explore greater depth from CAMERA2 trial.Among participants trial, demographic-related, infection-related treatment-related were assessed their relationship by univariable multivariable logistic regression. Acute defined a modified-KDIGO (Kidney Disease: Improving Global Outcomes) criteria (not including urinary output).Of 266 included, age (p = 0.04), randomisation 0.002), vancomycin area under concentration-time curve 0.03) receipt (flu)cloxacillin as companion beta-lactam < 0.001) associated injury. On analysis, concurrent use increased over four times cefazolin or no beta-lactam. The association also persisted model.For receiving These represent potentially modifiable highlight importance avoiding nephrotoxins.