期刊
CURRENT OPINION IN PHARMACOLOGY
卷 24, 期 -, 页码 1-6出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.coph.2015.06.002
关键词
-
资金
- National Health and Medical Research Council of Australia [APP1048652]
The renal clearance of antibiotics may be elevated in some critically ill patients. This paper reviews this recently described phenomenon, referred to as augmented renal clearance (ARC). ARC is considered to be driven by pathophysiological elevation of glomerular filtration, and is defined as a creatinine clearance >130 mL/min/173 m(2). This in turn promotes very low antibiotic concentrations. This effect may lead to adverse clinical outcomes, particularly with beta-lactam antibiotics, as they require prolonged exposure for optimal antibacterial activity. The use of extended or continuous infusions is an effective strategy to improve exposure. However, because the effect of ARC is potentially quite variable, regular therapeutic drug monitoring (TDM) may be necessary to ensure all patients achieve effective concentrations.
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