Frontiers in Pharmacology (May 2020)

Recommendation of Antimicrobial Dosing Optimization During Continuous Renal Replacement Therapy

  • Lu Li,
  • Xin Li,
  • Yanzhe Xia,
  • Yanqi Chu,
  • Haili Zhong,
  • Jia Li,
  • Pei Liang,
  • Yishan Bu,
  • Rui Zhao,
  • Yun Liao,
  • Ping Yang,
  • Xiaoyang Lu,
  • Saiping Jiang

DOI
https://doi.org/10.3389/fphar.2020.00786
Journal volume & issue
Vol. 11

Abstract

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Continuous Renal Replacement Therapy (CRRT) is more and more widely used in patients for various indications recent years. It is still intricate for clinicians to decide a suitable empiric antimicrobial dosing for patients receiving CRRT. Inappropriate doses of antimicrobial agents may lead to treatment failure or drug resistance of pathogens. CRRT factors, patient individual conditions and drug pharmacokinetics/pharmacodynamics are the main elements effecting the antimicrobial dosing adjustment. With the development of CRRT techniques, some antimicrobial dosing recommendations in earlier studies were no longer appropriate for clinical use now. Here, we reviewed the literatures involving in new progresses of antimicrobial dosages, and complied the updated empirical dosing strategies based on CRRT modalities and effluent flow rates. The following antimicrobial agents were included for review: flucloxacillin, piperacillin/tazobactam, ceftriaxone, ceftazidime/avibactam, cefepime, ceftolozane/tazobactam, sulbactam, meropenem, imipenem, panipenem, biapenem, ertapenem, doripenem, amikacin, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin, azithromycin, tigecycline, polymyxin B, colistin, vancomycin, teicoplanin, linezolid, daptomycin, sulfamethoxazole/trimethoprim, fluconazole, voriconazole, posaconzole, caspofungin, micafungin, amphotericin B, acyclovir, ganciclovir, oseltamivir, and peramivir.

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