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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Antibiotic Dosing in Critically Ill Patients Undergoing Renal Replacement Therapy

Gregory M Susla1

  • 1Gregory M. Susla is President, Washington DC Area Critical Care Society, 5301 Hines Rd, Frederick, MD 21704 (gsusla@att.net).

AACN Advanced Critical Care
|July 23, 2015
PubMed

Insights

Dosing antibiotics for critically ill patients on continuous renal replacement therapy requires careful consideration of the therapy method and patient factors. Dosing must be adjusted based on the renal replacement circuit and the patient

Area of Science:

  • Critical care medicine
  • Nephrology
  • Pharmacology

Background:

  • Continuous renal replacement therapy (CRRT) is vital for acute renal failure in critically ill patients.
  • Infections are common in these patients, necessitating antibiotic treatment.
  • Standard antibiotic dosing may be ineffective due to altered drug clearance during CRRT.

Purpose of the Study:

  • To highlight the importance of individualized antibiotic dosing in critically ill patients undergoing CRRT.
  • To emphasize the need for a tailored approach to antibiotic selection and administration.

Main Methods:

  • Review of current literature on antibiotic pharmacokinetics and pharmacodynamics during CRRT.
  • Analysis of factors influencing antibiotic dosing, including CRRT modality and residual renal function.
  • Discussion of monitoring and adjustment strategies for antibiotic regimens.

Main Results:

  • Antibiotic clearance varies significantly with different CRRT methods.
  • Residual renal function plays a crucial role in drug elimination.
  • Microorganism sensitivity testing is essential for effective treatment selection.

Conclusions:

  • Optimized antibiotic dosing is critical for successful infection management in CRRT patients.
  • Regimens require continuous monitoring and adjustment based on circuit changes and patient status.
  • A multidisciplinary approach involving nephrologists and infectious disease specialists is recommended.

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