[Antibiotic dosing for renal function disorders and continuous renal replacement therapy].

[Antibiotic dosing for renal function disorders and continuous renal replacement therapy].
Anaesthesist. 2015 Mar 27;
Authors: Michael E, Kindgen-Milles D
Abstract
For patients with acute kidney injury (AKI) and continuous renal replacement therapy, it is essential that the dosing of antibiotics is adequately adjusted in order to achieve an effective drug level above the minimum inhibition concentration but avoiding toxic side effects. In the selection of substances, preference should be given to antibiotics with a broad therapeutic spectrum, low incidence of side effects and, as far as possible, extrarenal elimination. Determination of serum levels should always be carried out, when this is possible. In any case, a sufficiently high loading dose should be included. An accurate as possible estimation of residual renal function and calculation of the mechanical clearance allows determination of the necessary maintenance dosage, which is acceptably accurate for clinical needs. Recent studies have shown that under modern continuous renal replacement therapy, the extent of elimination of antibiotics is regularly underestimated so that nowadays, the risk of antibiotic underdosing is higher than toxicity due to overdosing.
PMID: 25812546 [PubMed - as supplied by publisher]

Source: Der Anaesthesist - March 27, 2015 Category: Anesthesiology Authors: Michael E, Kindgen-Milles D Tags: Anaesthesist Source Type: research