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When renal excreted agents are administered to patients, it is important to understand the kidney functions of patients. We therefore investigated the use trend of renal excreted agents and the kidney function on inpatients after undergoing digestive organ surgery in order to select the most suitable agents in nephropathy. Antibiotics were most frequently used in digestive organ surgery are mostly renal excreted agents. These agents were often administered to patients whose creatinine clearance levels were less than 60 mL/min. These patients require an optimal dosage of antibiotics because most antibiotics correlate with the creatinine clearance level. The predicted creatinine clearance, as calculated by the Cockcroft-Gault formula, is often used in clinical practice to evaluate the kidney function. In this case, we must consider the difference between the observed and the predicted creatinine clearance level. If we determine the optimal dosage by the predicted creatinine clearance, the dose of flomoxef or levofloxacin were underestimated in approximately 30% of patients treated with these agents. Therefore, the creatinine clearance of patients must be assessed by evaluating such vital signs as the urine volume in addition to the serum creatinine level. In addition, pharmacists must pay careful attention to the clinical characteristics in addition to the kidney function of patients when determining the optimal dosage of renal excreted agents.

Relation between Kidney Function and Use Trend of Renal Excreted Agents on Inpatients of Digestive Organ Surgery in Hirosaki University Hospital.