Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies
Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT) due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/3235765 |
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| author | Anna P. Kempke Abbie S. Leino Farzad Daneshvar John Andrew Lee Bruce A. Mueller |
| author_facet | Anna P. Kempke Abbie S. Leino Farzad Daneshvar John Andrew Lee Bruce A. Mueller |
| author_sort | Anna P. Kempke |
| collection | DOAJ |
| description | Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT) due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature search of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic data acquired from patients with acute and chronic kidney disease as well as healthy volunteers. These data and that obtained from drug package inserts were gathered for use in three published CRRT drug dosing equations. Doses calculated for a model patient using each method were compared to doses suggested in a commonly used dosing text. Results. Full pharmacokinetic data was available for 18, 31, and 40 agents using acute kidney injury, end stage renal disease, and normal patient data, respectively. On average, calculated doses differed by 30% or more from the doses recommended by the renal dosing text for >50% of the medications. Conclusion. Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are used. Alternate, validated dosing methods need to be developed for this at-risk patient population. |
| format | Article |
| id | doaj-art-4ad0fdd32a4742baa6b7458a07389efc |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-4ad0fdd32a4742baa6b7458a07389efc2025-02-03T06:11:06ZengWileyCritical Care Research and Practice2090-13052090-13132016-01-01201610.1155/2016/32357653235765Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing StrategiesAnna P. Kempke0Abbie S. Leino1Farzad Daneshvar2John Andrew Lee3Bruce A. Mueller4Clinical Pharmacy Department, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USAClinical Pharmacy Department, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USAClinical Pharmacy Department, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USAClinical Pharmacy Department, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USAClinical Pharmacy Department, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USAPurpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT) due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature search of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic data acquired from patients with acute and chronic kidney disease as well as healthy volunteers. These data and that obtained from drug package inserts were gathered for use in three published CRRT drug dosing equations. Doses calculated for a model patient using each method were compared to doses suggested in a commonly used dosing text. Results. Full pharmacokinetic data was available for 18, 31, and 40 agents using acute kidney injury, end stage renal disease, and normal patient data, respectively. On average, calculated doses differed by 30% or more from the doses recommended by the renal dosing text for >50% of the medications. Conclusion. Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are used. Alternate, validated dosing methods need to be developed for this at-risk patient population.http://dx.doi.org/10.1155/2016/3235765 |
| spellingShingle | Anna P. Kempke Abbie S. Leino Farzad Daneshvar John Andrew Lee Bruce A. Mueller Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies Critical Care Research and Practice |
| title | Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies |
| title_full | Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies |
| title_fullStr | Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies |
| title_full_unstemmed | Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies |
| title_short | Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies |
| title_sort | antimicrobial doses in continuous renal replacement therapy a comparison of dosing strategies |
| url | http://dx.doi.org/10.1155/2016/3235765 |
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