Title |
Augmented renal clearance and therapeutic monitoring of β-lactams
|
---|---|
Published in |
International Journal of Antimicrobial Agents, January 2015
|
DOI | 10.1016/j.ijantimicag.2014.12.020 |
Pubmed ID | |
Authors |
Andrew A. Udy, Jan J. De Waele, Jeffrey Lipman |
Abstract |
Successful application of antibacterial therapy in the critically ill requires an appreciation of the complex interaction between the host, the causative pathogen and the chosen pharmaceutical. A pathophysiological change in the intensive care unit (ICU) patient challenging the 'one dose fits all' concept includes augmented renal clearance (ARC), defined as a creatinine clearance (CLCr) of ≥130mL/min. Ideally, CLCr values should be obtained by a timed measured collection of urine, with plasma and urine creatinine levels. Increased renal clearance of antibiotics also occurs in the ICU patient and therefore β-lactam antibiotic exposure in the critically ill could easily lead to trough drug concentrations below therapeutic ranges. One way to document and alter drug levels is via therapeutic drug monitoring (TDM). The interactions of ARC and β-lactam TDM are further explored in this article in specific reference to a concomitant article in this issue of the journal. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 50% |
Belgium | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 50% |
Scientists | 1 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Japan | 1 | 2% |
United States | 1 | 2% |
France | 1 | 2% |
Canada | 1 | 2% |
Unknown | 52 | 93% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 11 | 20% |
Student > Master | 8 | 14% |
Other | 7 | 13% |
Student > Ph. D. Student | 6 | 11% |
Student > Doctoral Student | 4 | 7% |
Other | 13 | 23% |
Unknown | 7 | 13% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 24 | 43% |
Pharmacology, Toxicology and Pharmaceutical Science | 13 | 23% |
Biochemistry, Genetics and Molecular Biology | 3 | 5% |
Chemistry | 2 | 4% |
Immunology and Microbiology | 1 | 2% |
Other | 2 | 4% |
Unknown | 11 | 20% |