Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing

Sepsis, a dysregulated host response to infection is common in the intensive care unit (ICU) worldwide. It remains a major challenge for critical care physicians because of the associated high mortality and morbidity. According to Malaysian Registry of Intensive Care (MRIC) Report in 2017, sepsis wa...

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Main Authors:	Mat Nor, Mohd Basri, Abdul Rahim, Shahir Asraf
Format:	Article
Language:	English
Published:	Malaysian Society of Anaesthesiologists 2019
Subjects:	RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Online Access:	http://irep.iium.edu.my/79135/ http://irep.iium.edu.my/79135/ http://irep.iium.edu.my/79135/1/MSA%20Yr%20Book%20201819%20-Basri%20Mat%20Nor.pdf

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recordtype	eprints
spelling	iium-791352020-02-28T08:37:15Z http://irep.iium.edu.my/79135/ Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing Mat Nor, Mohd Basri Abdul Rahim, Shahir Asraf RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid Sepsis, a dysregulated host response to infection is common in the intensive care unit (ICU) worldwide. It remains a major challenge for critical care physicians because of the associated high mortality and morbidity. According to Malaysian Registry of Intensive Care (MRIC) Report in 2017, sepsis was the first leading cause of admission to the Ministry of Health ICUs with mortality rate of 52.8%.1 In management of critically ill patients with sepsis and septic shock, there is compelling evidence that source control of the pathogen, early and appropriate administration of antimicrobial therapy remain the most important intervention. To achieve favourable outcomes, the goal is to achieve effective drug concentrations at the site of infection. In critically ill patients, development of organ failure may complicate antibiotic dosing. Two pharmacokinetic parameters that vary with greatest significance in patients with MODS are Vd and drug CL. In presence of AKI, antibiotic dose adjustments in patients with reduced clearance are commonly applied to avoid adverse effects. Augmented renal clearance is another important phenomenon which is a manifestation of enhanced renal function. Early recognition of patients at risk of ARC allows further intervention to prevent antibiotic failure. In patients with ARC, higher doses of renal eliminated antibiotics are recommended or administration of non-renally eliminated drugs should be considered. Malaysian Society of Anaesthesiologists 2019-11 Article NonPeerReviewed application/pdf en http://irep.iium.edu.my/79135/1/MSA%20Yr%20Book%20201819%20-Basri%20Mat%20Nor.pdf Mat Nor, Mohd Basri and Abdul Rahim, Shahir Asraf (2019) Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing. Malaysian Society of Anaesthesiologists Year Book 2018/2019. pp. 45-54. ISSN 2462-1307 http://www.msa.net.my
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
spellingShingle	RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid Mat Nor, Mohd Basri Abdul Rahim, Shahir Asraf Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
description	Sepsis, a dysregulated host response to infection is common in the intensive care unit (ICU) worldwide. It remains a major challenge for critical care physicians because of the associated high mortality and morbidity. According to Malaysian Registry of Intensive Care (MRIC) Report in 2017, sepsis was the first leading cause of admission to the Ministry of Health ICUs with mortality rate of 52.8%.1 In management of critically ill patients with sepsis and septic shock, there is compelling evidence that source control of the pathogen, early and appropriate administration of antimicrobial therapy remain the most important intervention. To achieve favourable outcomes, the goal is to achieve effective drug concentrations at the site of infection. In critically ill patients, development of organ failure may complicate antibiotic dosing. Two pharmacokinetic parameters that vary with greatest significance in patients with MODS are Vd and drug CL. In presence of AKI, antibiotic dose adjustments in patients with reduced clearance are commonly applied to avoid adverse effects. Augmented renal clearance is another important phenomenon which is a manifestation of enhanced renal function. Early recognition of patients at risk of ARC allows further intervention to prevent antibiotic failure. In patients with ARC, higher doses of renal eliminated antibiotics are recommended or administration of non-renally eliminated drugs should be considered.
format	Article
author	Mat Nor, Mohd Basri Abdul Rahim, Shahir Asraf
author_facet	Mat Nor, Mohd Basri Abdul Rahim, Shahir Asraf
author_sort	Mat Nor, Mohd Basri
title	Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
title_short	Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
title_full	Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
title_fullStr	Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
title_full_unstemmed	Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
title_sort	pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing
publisher	Malaysian Society of Anaesthesiologists
publishDate	2019
url	http://irep.iium.edu.my/79135/ http://irep.iium.edu.my/79135/ http://irep.iium.edu.my/79135/1/MSA%20Yr%20Book%20201819%20-Basri%20Mat%20Nor.pdf
first_indexed	2023-09-18T21:51:16Z
last_indexed	2023-09-18T21:51:16Z
_version_	1777413785565265920

Pharmacology in intensive care patients: the role of renal clearance in antibiotic dosing

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