Since antibiotics are mainly excreted by the kidneys, the dose should be reduced in patients with renal impairment. In practice, however, this often does not happen because doctors are afraid of undertreatment and because guidelines are not clear. Physician-researcher Suzanne de Vroom looked into her doctoral research whether that is correct.
De Vroom found in a literature review that the recommended dose reduction for only 1 antibiotic (meropenem) has been properly investigated. So there is little evidence. De Vroom and her colleagues therefore investigated for 2 important antibiotics – ciprofloxacin and ceftazidime – whether the current dose reduction in patients with renal insufficiency is equivalent and effective compared to patients with good renal function who received the standard dose. This did not seem to be the case for ciprofloxacin, but it was for ceftazidime. They conclude this on the basis of the rapid and accurate measurement method for the total and active plasma concentration of ciprofloxacin that they developed and validated (liquid chromatography tandem mass spectrometry).
De Vroom wrote her thesis entitled ‘Antibiotic dose optimization for specific patient populations: With focus on patients with renal impairment’ under the supervision of Prof. Dr. SE Geerlings, Prof. Dr. RAA Mathôt and Dr. RM van Hest and obtained her PhD on 25 May at the University of Amsterdam.
Bron:
2023-06-07 08:34:15
#PhD #Defence #optimal #dose #antibiotics #patients #renal #insufficiency #MedNet
