Appropriateness of Antibiotic Dosing in Patients with Augmented Renal Clearance in Cardiovascular Surgery and Coronary Intensive Care Units.

Authors

Ayse Gul Kocoglu Kinal, Yunus Emre Ayhan

Published in

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. Volume 36. Issue 9. Pages 1200-1204.

Abstract

To evaluate the appropriateness of antibiotic dosing in patients with augmented renal clearance (ARC) admitted to the cardiovascular surgery intensive care unit (CVS-ICU) and the coronary intensive care unit (CICU).
A descriptive study. Place and Duration of the Study: CVS-ICU and CICU, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye, from January 2024 to January 2025.
Adult patients (≥18 years) hospitalised for ≥24 hours, diagnosed with ARC (eGFR ≥130 mL/min/1.73 m2), and receiving antibiotics were included. Dosing appropriateness was assessed based on UpToDate® recommendations. ARC risk was stratified using the ARC scoring system. Data were analysed using descriptive statistics, chi-square test, and Mann-Whitney U test.
Of the 3,334 screened patients, 83 (2.5%) met ARC criteria; 57 received antibiotics and were included in the analysis. At least one dosing error was identified in 84.2% of cases, mostly underdosing (73.1%). The most common antibiotics were cefazolin (42.6%), ampicillin-sulbactam (14.6%), and daptomycin (7.3%). A high ARC risk score was associated with a greater likelihood of dosing errors (90.4% vs. 66.6%; OR = 4.7, p = 0.044). Patients with dosing errors were younger (median 25.5 vs. 50 years, p = 0.004) and received more antibiotics (p = 0.038).
Although ARC was uncommon, dosing errors were frequent. Early recognition of ARC and individualised dosing are critical to optimise therapy in ICU patients.
Augmented renal clearance, Antibiotic dosing, Cardiovascular surgery intensive care unit, Coronary intensive care unit, Dose adjustment.

PMID:
42698253
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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