Antibiotic dosing in critically ill adult patients receiving continuous renal replacement therapy.
Continuous renal replacement therapy (CRRT) is now commonly used as a means of support for critically ill patients with renal failure. No recent comprehensive guidelines exist that provide antibiotic dosing recommendations for adult patients receiving CRRT. Doses used in intermittent hemodialysis cannot be directly applied to these patients, and antibiotic pharmacokinetics are different than those in patients with normal renal function. We reviewed the literature for studies involving the following antibiotics frequently used to treat critically ill adult patients receiving CRRT: vancomycin, linezolid, daptomycin, meropenem, imipenem-cilastatin, nafcillin, ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanic acid, cefazolin, cefotaxime, ceftriaxone, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin, colistin, amikacin, gentamicin, tobramycin, fluconazole, itraconazole, voriconazole, amphotericin B (deoxycholate and lipid formulations), and acyclovir. We used these data, as well as clinical experience, to make recommendations for antibiotic dosing in critically ill patients receiving CRRT.
Trotman
Robin L
RL
Department of Internal Medicine, Section of Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, North Carolina 27157, USA. rtrotman@wfubmc.edu
Williamson
John C
JC
Shoemaker
D Matthew
DM
Salzer
William L
WL
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D051437:Renal Insufficiency / Q000628:therapy*; D017582:Renal Replacement Therapy
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents