| Popis: |
Objective Assessment of dosage deviations of 3 β-lactam antibiotics eliminated through the kidneys (meropenem, piperacillin/tazobactam, and cefepime) by comparison of 2 prediction formulae, Cockroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) with 24 h urinary creatinine clearance (CrCl24h), as a reference method. Method 125 samples of 61 critically ill patients (each one with CG, MDRD and CrCl24h values) were classified in one of the 5 stages of the National Kidney Foundation (NKF) according to CrCl24h. Dosage discrepancies for each antibiotic based on CG and MDRD were studied in reference to CrCl24h by percentage agreement and weighted kappa. At each of the NKF stages, daily dosage differences (β=DoseCG-DoseCrCl24h; β=DoseMDRDDoseCrCl24h) and percentage of samples with dosage discrepancies by CG and MDRD in reference to CrCl24h were calculated. Results There were no statistically significant differences between the 2 prediction formulae in respect to CrCl24h, achieving good degrees of concordance. Deviation percentages fluctuated between 15.2% and 28% and occurred mainly by underdosing on stages 1 and 2 and by overdosing on stages 4 and 5. Conclusions The 2 renal function prediction formulae can be indistinctly used to optimize the β-lactam antibiotics dose regimen, CG being the easiest one. |
