title: Appropriate antibiotic dosing in severe sepsis and acute renal failure: factors to consider.
abstract: Severe sepsis and septic shock cause considerable morbidity and mortality. Early appropriate empiric broad-spectrum antibiotics and advanced resuscitation therapy are the cornerstones of treatment for these conditions. In prescribing an antibiotic regimen in septic patients with acute renal failure treated with continuous renal replacement therapy, several factors should be considered: pharmacokinetics, weight, residual renal function, hepatic function, mode of renal replacement therapy (membrane and surface area, sieving coefficient, effluent and dialysate rate, and blood flow rate), severity of illness, microorganism, minimum inhibitory concentration, and others. Studies that determine the serum antibiotic concentrations are very useful in establishing the correct dosage in critical patients.
authors.affiliation: Critical Care Department, Mutua Terrassa University Hospital, University of Barcelona, Plaça Dr, Robert 5, Terrassa 08221, Barcelona, Spain. 29421rfr@comb.cat
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: González de Molina
authors.forename: Ricard
authors.initials: R
authors.lastname: Ferrer
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008297:Male; D017582:Renal Replacement Therapy / Q000379:methods*; D012772:Shock, Septic / Q000628:therapy*; D047090:beta-Lactams / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams