Antibiotics and chronic kidney disease: Dose adjustment update for infectious disease clinical practice

Aloy, Blandine; Launay-Vacher, Vincent; Bleibtreu, Alexandre; Bortolotti, Perrine; Faure, Emmanuel; Filali, A.; Gauzit, R.; Gilbert, Marius; Lesprit, Philippe; Mahieu, Rafaël; Meyssonnier, Vanina; Ogielska, Maja; Romaru, Juliette; Salmon, Dominique; Alfandari, S.; Lemaignen, Adrien

doi:10.1016/j.medmal.2019.06.010

Cited by 24 publications

(20 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The doses must be modified such that adequate therapeutic concentrations reach the kidney and, subsequently, the urine. 11 Failure of these enhances the possibility of resistance emerging to the antibiotics used. Therefore, therapeutic drug monitoring is crucial for these groups.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic utilization study in a teaching hospital in Nigeria

Sekoni

Oreagba

Oladoja

2022

JAC-Antimicrobial Resistance

View full text Add to dashboard Cite

Background Antibiotics have been the bedrock of modern medical care, particularly bacterial infections. However, globally, antimicrobial resistance has become a well-recognized public health threat in recent years, and interventions to reduce its burden have been launched worldwide. Objectives The present study evaluated antibiotic utilization in both hospitalized patients and outpatients in a University Hospital in Nigeria. Methods In a 3 year retrospective study between January 2017 and December 2019, 246 case files of patients were selected for the study based on inclusion and exclusion criteria. In addition, the antibiotic consumption rate for hospitalized and outpatients was determined. Results The total antibiotic consumption for hospitalized patients in this study was 260.9 DDD/100 bed-days, while the outpatient department’s patients were 72.3 DDD/1000 inhabitants per day. Peptic ulcer disease was the most frequent indication for antibiotic use for outpatients, with the fluoroquinolones and macrolides being the most prescribed antibiotic class and antibiotic class with the highest DDD, respectively. The most frequent indication for antibiotic use for hospitalized patients was chronic kidney diseases, with the fluoroquinolones and second-generation cephalosporins being the most prescribed antibiotic class and antibiotic class with the highest DDD, respectively. DDD per 100 bed-days and DDD per 1000 patient-days were highest in 2018. The P values for the years were 0.019, 0.195 and 0.001 for 2017, 2018 and 2019, respectively. Conclusions Our findings revealed irrationality in antibiotic use. Therefore, antimicrobial stewardship programmes should be implemented.

show abstract

Section: Discussionmentioning

confidence: 99%

Antibiotic utilization study in a teaching hospital in Nigeria

Sekoni

Oreagba

Oladoja

2022

JAC-Antimicrobial Resistance

View full text Add to dashboard Cite

show abstract

“…This method works well with medications that have a broad therapeutic window and a long half-life, such as penicillin and cephalosporins [51]. It is worth noting that, for antibacterial drugs with a concentrationdependent kill rate, this method is appropriate, while for those with time-dependent activity, the "constant-interval, dose-reduction" method is recommended to maintain plasma concentrations above the minimum inhibitory concentration (MIC) [50][51][52]57]. When a dosage adjustment is required, the risks of subtherapeutic serum concentrations must be weighed against the risks of adverse events.…”

Section: Rational Design Of Dosing Regimens In Ckd Patientsmentioning

confidence: 99%

“…In human patients with decreased renal function, potentiated penicillin has a decreased renal clearance, resulting in higher serum concentrations in comparison with patients with normal renal function; thus, since potentiated penicillin is predominately excreted by the kidneys, dose adjustment of potentiated penicillin (i.e., decreased dose or decreased frequency) has been recommended in human patients with a severe reduction in GFR (i.e., <30 mL/min) to avoid excessive drug accumulation [57,130].…”

Section: Penicillinsmentioning

confidence: 99%

“…Cephalosporins are a class of relatively safe antimicrobial agents; nevertheless, high doses or very prolonged use have been associated with interstitial nephritis and tubular necrosis [57,60]. With the exception of those which are mainly eliminated by the extrarenal route, such as cefoperazone or cefixime [118,132], cephalosporins clearance is decreased in human patients with renal failure, and a dosage regimen adjustment is recommended if a moderate-to-severe reduction in GFR occurs [63].…”

Section: Cephalosporinsmentioning

confidence: 99%

See 1 more Smart Citation

Drug-Dosing Adjustment in Dogs and Cats with Chronic Kidney Disease

Santis

Boari

Dondi

et al. 2022

Animals

View full text Add to dashboard Cite

Chronic kidney disease is a common kidney disorder in adult and aged dogs and cats; the management of associated complications and comorbidities generally requires a life-long medical treatment to ensure a good quality of life of affected patients. However, indications and the literature on drug dosing in dogs and cats with chronic kidney disease are often lacking. The aim of this review is to revise the current literature on drug dosing in canine and feline patients with renal impairment, with a special focus on the most commonly used medications to manage chronic kidney disease and possible comorbidities.

show abstract

“…An inappropriate dose adjustment could result in elevated plasma concentrations of the drug leading to adverse drug reactions, thus increasing the patient's burden 6 . Antibiotic dose optimization is an essential part of clinical practice for better clinical management and delayed resistance 7 . Antibiotic resistance not only increases healthcare costs but also worsens severity of infection 8 .…”

Section: Introductionmentioning

confidence: 99%

Dose Optimization of Antibiotics in Renally Impaired Patients in Indian Settings: A Prospective Observational Study

Sridhara¹,

Raj²,

Chandra³

et al. 2020

Preprint

View full text Add to dashboard Cite

Rationale: In renal impairment, the pharmacokinetic properties of the drug are altered, and the systemic clearance is reduced. The current study aimed to assess the optimization of antibiotics dosing in renally impaired patients in a healthcare setting. Methodology: A prospective study was conducted on in-patients in the nephrology department, prescribed with antibiotics in a tertiary care hospital. The creatinine clearance was calculated by Cockroft-Gault and Jelliffe method. The dose appropriateness was cross-checked using standard databases and literature from the manufacturer data. Results: Of 139 participants 112 (80.6%) had CKD and 27(19.4%) had AKI. Urinary tract infection was most common. Monotherapy (62) was the most preferred choice, followed by dual in (43) and triple in (7%). A positive clinical outcome of 79.1% was achieved. Cefoperazone-sulbactam was most widely used antibiotic. The mean difference in creatinine clearance was 4.55ml/min in AKI patients. Conclusion: Dose appropriateness is a significant factor in achieving favorable clinical outcomes.

show abstract

Antibiotics and chronic kidney disease: Dose adjustment update for infectious disease clinical practice

Cited by 24 publications

References 59 publications

Antibiotic utilization study in a teaching hospital in Nigeria

Antibiotic utilization study in a teaching hospital in Nigeria

Drug-Dosing Adjustment in Dogs and Cats with Chronic Kidney Disease

Dose Optimization of Antibiotics in Renally Impaired Patients in Indian Settings: A Prospective Observational Study

Contact Info

Product

Resources

About