Open AccessPharmacokinetics and pharmacodynamics of antibiotics in critically ill acute kidney injury patients
Author(s) -
Zamoner Welder,
Freitas Fernanda M.,
Garms Durval S. S.,
Oliveira Mariele Gobo,
Balbi André L.,
Ponce Daniela
Publication year - 2016
Publication title -
pharmacology research and perspectives
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.975
H-Index - 27
ISSN - 2052-1707
DOI - 10.1002/prp2.280
Subject(s) - medicine , intensive care medicine , acute kidney injury , pharmacodynamics , sepsis , renal replacement therapy , dialysis , antibiotics , critically ill , kidney disease , pharmacokinetics , microbiology and biotechnology , biology
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.