Pharmacokinetics and pharmacodynamics of antibiotics in critically ill acute kidney injury patients.
Welder ZamonerFernanda M de FreitasDurval S S GarmsMariele Gobo de OliveiraAndré L BalbiDaniela PoncePublished in: Pharmacology research & perspectives (2016)
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI. The current recommendations were extrapolated from studies conducted in noncritical patients with end-stage chronic kidney disease receiving chronic renal replacement therapy. This study aimed to review and discuss the complexity of this issue, considering several factors related to drug metabolism, the characteristics of critically ill patients, the properties of antimicrobial drugs and dialysis methods.
Keyphrases
- acute kidney injury
- end stage renal disease
- chronic kidney disease
- cardiac surgery
- peritoneal dialysis
- drug induced
- cardiovascular events
- clinical practice
- liver failure
- ejection fraction
- newly diagnosed
- risk factors
- staphylococcus aureus
- prognostic factors
- type diabetes
- emergency department
- adverse drug
- cardiovascular disease
- patient reported outcomes
- aortic dissection
- extracorporeal membrane oxygenation
- case control