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Critical Care
Published in: Critical Care 1/2018

Open Access 01-12-2018 | Letter

The kinetic glomerular filtration rate is not interchangeable with measured creatinine clearance for prediction of piperacillin underexposure in critically ill patients with augmented renal clearance

Authors: Cédric Carrié, Sébastien Rubin, Pierre Sioniac, Dominique Breilh, Matthieu Biais

Published in: Critical Care | Issue 1/2018

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Excerpt

In the critical care setting, augmented renal clearance (ARC) is increasingly recognized as one of the leading causes of subtherapeutic antibiotic exposure [1]. However, commonly used formulas for estimating glomerular filtration rate (GFR) are inaccurate in patients with ARC and the 24-h urinary creatinine clearance (CrCL) remains the best available approach for optimizing empirical antimicrobial therapy [2]. On the other hand, no study has evaluated the clinical and prognostic value of the kinetic estimated GFR (KeGFR) in this context. We thus aimed to determine whether KeGFR could be a reliable alternative to measured CrCL in critically ill patients needing early initiation of an appropriate piperacillin dosing regimen. …
Literature
1.
Udy AA, Lipman J, Jarrett P, Klein K, Wallis SC, Patel K, Kirkpatrick CM, Kruger PS, Paterson DL, Roberts MS, Roberts JA. Are standard doses of piperacillin sufficient for critically ill patients with augmented creatinine clearance? Crit Care. 2015;19:28.CrossRefPubMedPubMedCentral
2.
Barletta JF, Mangram AJ, Byrne M, Hollingworth AK, Sucher JF, Ali-Osman FR, Shirah GR, Dzandu JK. The importance of empiric antibiotic dosing in critically ill trauma patients: are we under-dosing based on augmented renal clearance and inaccurate renal clearance estimates? J Trauma Acute Care Surg. 2016;81(6):1115–21.CrossRefPubMed
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Carrié C, Petit L, d'Houdain N, Sauvage N, Cottenceau V, Lafitte M, Foumenteze C, Hisz Q, Menu D, Legeron R, Breilh D, Sztark F. Association between augmented renal clearance, antibiotic exposure and clinical outcome in critically ill septic patients receiving high doses of β-lactams administered by continuous infusion: a prospective observational study. Int J Antimicrob Agents. 2018;51(3):443–9.CrossRefPubMed
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Dewitte A, Joannès-Boyau O, Sidobre C, Fleureau C, Bats ML, Derache P, Leuillet S, Ripoche J, Combe C, Ouattara A. Kinetic eGFR and novel AKI biomarkers to predict renal recovery. Clin J Am Soc Nephrol. 2015;10(11):1900–10.CrossRefPubMedPubMedCentral
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Baptista JP, Udy AA, Sousa E, Pimentel J, Wang L, Roberts JA, Lipman J. A comparison of estimates of glomerular filtration in critically ill patients with augmented renal clearance. Crit Care. 2011;15(3):R139.CrossRefPubMedPubMedCentral
Metadata
Title
The kinetic glomerular filtration rate is not interchangeable with measured creatinine clearance for prediction of piperacillin underexposure in critically ill patients with augmented renal clearance
Authors
Cédric Carrié
Sébastien Rubin
Pierre Sioniac
Dominique Breilh
Matthieu Biais
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-018-2117-7

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