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Ampicillin administration and the incidence of severe acute kidney injury in patients with sepsis
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Ampicillin administration and the incidence of severe acute kidney injury in patients with sepsis
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Journal Article
Ampicillin administration and the incidence of severe acute kidney injury in patients with sepsis
2025
Overview
Acute kidney injury (AKI) affects 40-50% of septic patients, with limited prevention options. This study investigates the relationship between early ampicillin administration and severe AKI in septic patients.
A retrospective cohort study using the MIMIC-IV database (2008-2019) was conducted. The primary outcome was severe AKI, and secondary outcomes included continuous renal replacement therapy, in-hospital death, and any-stage AKI. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for confounders. Multivariate regression explored the association between ampicillin and severe AKI incidence, and subgroup analyses were performed.
A total of 17,676 septic patients were included, with 915 matched pairs after PSM. Ampicillin administration was associated with a reduced risk of severe AKI (OR = 0.78; 95% CI 0.68-0.90) in multivariable logistic regression, PSM (OR = 0.74; 95% CI 0.61-0.92), and IPTW (OR = 0.77; 95% CI 0.74-0.81). Incidence of acute kidney disease was lower in the ampicillin group (OR = 0.77; 95% CI 0.61-0.97). Mortality rates at 30 and 90 days were also lower (HR = 0.69; 95% CI 0.55-0.86 and OR = 0.67; 95% CI 0.55-0.82). The protective effect was more pronounced in female and older patients.
Early ampicillin administration within 48 h of ICU admission is associated with reduced severe AKI and improved short-term renal outcomes in septic patients. Further studies are needed to confirm these findings.
Publisher
Taylor & Francis Ltd,Taylor & Francis,Taylor & Francis Group
Subject
/ Acute Kidney Injury - epidemiology
/ Acute Kidney Injury - etiology
/ Acute Kidney Injury - mortality
/ Acute Kidney Injury - prevention & control
/ Aged
/ Ampicillin - administration & dosage
/ Ampicillin - therapeutic use
/ Anti-Bacterial Agents - administration & dosage
/ Anti-Bacterial Agents - therapeutic use
/ Female
/ Humans
/ Kidneys
/ Male
/ Patients
/ Renal Replacement Therapy - statistics & numerical data
/ Sepsis
