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Critical Care Infectious Diseases Textbook pp 297–312Cite as

Prescription of Antimicrobial Agents in Patients Undergoing Continuous Renal Replacement Therapy

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Abstract

Acute renal failure (ARF) is a frequent complication (10–30%) in critically ill patients, that is mostly part of a multi-organ dysfunction syndrome (MODS). Continuous renal replacement therapy (CRRT) is becoming the central component of the supportive care of these patients, especially in Europe and Australia, and appears to be superior to intermittent hemodialysis (IHD) in patients with hemodynamic instability, extracellular volume overload, cerebral oedema and hypercatabolism [1]. Sepsis is an important contributor to the pathogenesis of ARF [2] and most patients on CRRT are treated with antibiotics. Correct dosing of these antibiotics is of the utmost importance. Subtherapeutic levels may result in treatment failure and in the emergence of bacterial resistance [3, 4]. On the other hand, critically ill patients have a limited physiologic reserve in several organ systems and badly tolerate toxic effects.

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Authors
  1. M. Schetz
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  2. C. Verwaest
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Editors and Affiliations

  1. Hospital Universitari Joan XXIII, Tarragona, Spain

    Jordi Rello M.D., Ph.D.

  2. University Rovira & Virgili, Tarragona, Spain

    Jordi Rello M.D., Ph.D.

  3. Corporacio Sanitaria Parc Tauli, Sabadell, Barcelona, Spain

    Jordi Valles M.D., Ph.D.

  4. Washington University School of Medicine, St. Louis, Missouri, USA

    Marin H. Kollef M.D.

  5. Barnes-Jewish Hospital, St. Louis, Missouri, USA

    Marin H. Kollef M.D.

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Schetz, M., Verwaest, C. (2001). Prescription of Antimicrobial Agents in Patients Undergoing Continuous Renal Replacement Therapy. In: Rello, J., Valles, J., Kollef, M.H. (eds) Critical Care Infectious Diseases Textbook. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1679-8_16

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