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Antimicrobial dosing in critically ill patients with sepsis-induced acute kidney injury

Anish Kumar1, Narinder Pal Singh1

  • 1Department of Nephrology, Pushpanjali Crosslay Hospital, Ghaziabad, Uttar Pradesh, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|February 28, 2015
PubMed
Abstract

Insights

Optimizing antimicrobial dosing in sepsis-induced acute kidney injury (AKI) is crucial. This review examines challenges and strategies for effective antimicrobial therapy in critically ill patients with AKI.

Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Infectious Diseases

Background:

  • Sepsis frequently causes multiple organ dysfunction syndromes (MODS), notably acute kidney injury (AKI).
  • AKI impacts roughly 35% of ICU patients, with sepsis being the primary cause.
  • Sepsis-induced AKI carries a high mortality rate.

Purpose of the Study:

  • To outline appropriate antimicrobial dosing strategies for sepsis-induced AKI.
  • To review factors complicating precise antimicrobial dosing guidelines in these patients.

Main Methods:

  • Systematic literature search of PubMed and Google databases.
  • Inclusion of original articles published between 1978 and 2013.

Main Results:

  • Inappropriate antimicrobial use is linked to therapeutic failure, increased mortality, higher costs, toxicity, and antimicrobial resistance.
  • Antimicrobial therapy is complex due to altered pharmacokinetics, dynamic patient status, and frequent need for renal replacement therapy.

Conclusions:

  • Establishing precise antimicrobial dosing guidelines for sepsis-induced AKI is challenging.
  • Careful consideration of patient-specific factors is essential for effective antimicrobial treatment in AKI.
  • Optimized dosing is vital to improve outcomes and combat resistance.
Keywords:
Acute kidney injuryantimicrobial agentscritically ill patientmultiple organ dysfunction syndromespharmacodynamicspharmacokineticssepsis

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