Zamora GIS, Falla SHM, Gómez ZÁF, Cortés RJS, Flores HY, López FJ

Language: Spanish
References: 13
Page: 497-502
PDF size: 309.22 Kb.

ABSTRACT

Introduction: sepsis, the main cause of acute kidney injury (AKI) in intensive care unit (ICU) patients, is associated with high mortality (60-80%). Although renal replacement therapies have advanced, there are no validated guidelines for adjusting antibiotic doses in critically ill patients with AKI. This work addresses the pharmacokinetic and pharmacodynamic factors that influence antibiotic therapy in these cases. Objectives: to investigate the impact of antibiotic dose adjustment according to glomerular filtration rate (GFR) in patients with sepsis-induced AKI, evaluating outcomes such as days of ICU stay, mechanical ventilation and vasopressor support. Material and methods: an observational, descriptive and retrospective study was carried out in a third level ICU between August 2022 and August 2023. Nineteen patients older than 18 years with AKI according to KDIGO criteria and sepsis were included, comparing those with standard antibiotic doses and doses adjusted by GFR. Nonparametric analysis was used for correlations and primary and secondary outcomes. Results: 68.4% of patients received standard doses, while only 31.6% had GFR adjustments. No significant differences were found in days of ICU stay (mean 4.21 days), mechanical ventilation (mean 2.47 days) or use of vasopressor support (mean 3.16 days) between both groups. There was also no significant correlation between antibiotic adjustment and clinical outcomes (r(ho) 0.121, r(ho) of 0.01). Conclusion: antibiotic dose adjustment based on GFR did not demonstrate significant clinical benefits in the patients studied. Limitations of the study: its retrospective design and the lack of plasma drug determinations underscore the need for further research to optimize antibiotic therapy in critically ill patients with AKI and sepsis.

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