Journal of Medical and Surgical Intensive Care Medicine 2018 , Vol 9, Issue 1
Drug Use in Continuous Renal Replacement Therapy and the Comparison of Electronic Drug Information Resources for Dose Adjustments
Nursel Sürmelioğlu 1 , Ecem Köseleci 1 , Burcu Kelleci 1 , Nadir Yalçın 1 , Aygin Bayraktar Ekincioğlu 1 , Kutay Demirkan 1 , Arzu Topeli İskit 2
1Hacettepe Üniversitesi Eczacılık Fakültesi, Klinik Eczacılık Anabilim Dalı, Ankara, Türkiye
2Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Yoğun Bakım Bilim Dalı, Ankara, Türkiye
DOI : 10.5152/dcbybd.2018.1701

Objective: Continuous renal replacement therapy (CRRT) is frequently used for critically ill patients with acute renal failure. However, information on drug dosing in CRRT is limited; therefore, electronic resources of information are generally used. The aim of this study is to compare the dosing recommendations provided by five different commonly used electronic drug information resources regarding dose adjustments for the antimicrobial drugs used in CRRT.

Material and Methods
: Electronic drug information sources The Sanford Guide to Antimicrobial Therapy, Micromedex®, Kidney Disease Program (KDP), Medscape, and UpToDate® were reviewed by clinical pharmacists in order to compare CRRT-related recommendations for 25 most frequently used antimicrobial drugs (ampicillin, piperacillin/tazobactam, ceftriaxone, cefepime, cefotaxime, meropenem, trimethoprim/sulfamethoxazole, clarithromycin, tigecycline, ciprofloxacin, moxifloxacin, amikacin, vancomycin, teicoplanin, colistin, metronidazole, amphotericin B, caspofungin, anidulafungin, fluconazole, voriconazole, posaconazole, acyclovir, ganciclovir, and oseltamivir) in Hacettepe University Hospitals Medical Intensive Care Units.

: The Sanford Guide to Antimicrobial Therapy, KDP, and UpToDate® included detailed information and/or recommendations regarding drug dosing in CRRT compared to Micromedex® and Medscape. Dosing recommendations according to the CRRT type were only listed in Micromedex® and UpToDate® databases. The Sanford Guide to Antimicrobial Therapy, Micromedex®, KDP, and UpToDate® contained references about recommendations for some of the antimicrobial drugs. The differences in recommendations of electronic resources were detected particularly for piperacillin/tazobactam, trimethoprim/sulfamethoxazole, amikacin, vancomycin, colistin, and voriconazole.

: The dosing recommendations for drug use in CRRT available at one particular electronic resource should not be considered as “one size fits all”. There are few studies evaluating the dosing of antimicrobial drugs for patients receiving CRRT, and variations in recommendations exist among the information sources. The optimal drug regimen should be confirmed by using different resources, and the patient’s clinical response should be closely monitored.

Cite this article as
: Sürmelioğlu N, Köseleci E, Kelleci B, et al. Drug Use in Continuous Renal Replacement Therapy and the Comparison of Electronic Drug Information Resources for Dose Adjustments. Yoğun Bakım Derg 2018; 9 (1): 7-11.

Keywords : Renal replacement therapy, resource guides, antimicrobials, dose adjustment