Inconsistency exists between many guidelines in the recommended dose reduction of antibiotics in patients with impaired renal function. We performed a systematic review on the extent and quality of scientific evidence of these recommendations.
Results show that sound evidence is lacking. For this reasons we investigate the adequacy of the currently used dosing regimens of ciprofloxacin and ceftazidime. Both antibiotics are frequently prescribed in clinical practice and for both antibiotics a dose reduction is recommended for patients with impaired renal function. Dosing regimens are considered adequate if the relevant pharmacokinetic-pharmacodynamic target (PK-PD target) is attained.
Additionally, we investigate PK-PD target attainment of ciprofloxacin as infection prophylaxis in patients with haematological malignancies. Although pharmacokinetics of antibiotics are likely to be changed by altered drug absorption due to adverse effects of cytostatic agents, like mucositis, diarrhea and vomiting and changes in distribution, metabolism and excretion, PK-PD target attainment of the most frequently prescribed antibiotic in those patients has never been investigated. With results of our studies we try to optimize the antibiotic dosing regimens in order to improve patient’s outcome and minimize the risk of bacterial resistance.
The project group has received a grant from Stichting de Merel to prospectively validate improved dosing regimens of ciprofloxacin for patients with impaired renal function.
Project group: S.L. de Vroom1, dr. R.M. van Hest2, prof. dr. R.A.A. Mathôt2 and prof. dr. S.E. Geerlings1.
Other investigators: dr. F.V. van Daalen1, dr. N.G.L. Jager2, S.D. Kuil3, S.E. Zieck2.
- Amsterdam UMC, University of Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Infection and Immunity (AI&II), Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Hospital Pharmacy, Division of Clinical Pharmacology, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Meibergdreef 9, Amsterdam, Netherlands