CLINICAL ASSESSMENT OF ANTIBIOTICS USED IN CHRONIC KIDNEY DISEASE: A LONGITUDINAL OBSERVATIONAL STUDY
DOI:
https://doi.org/10.22159/ijpps.2024v16i10.52103Keywords:
Chronic kidney disease, Creatine clearance, Antibiotics, Clinical assessmentAbstract
Objective: The study was conducted to clinically evaluate the safety and efficacy of antibiotic drug consumption based on laboratory data, specifically White Blood Cells(WBC) and Glomerular Filtration Rate (GFR) before and after antibiotic use in patients with chronic kidney disease.
Methods: This retro-prospective longitudinal study was conducted on 115 patients with Chronic Kidney Disease (CKD) based on 6 mo of data at a tertiary care teaching institute, Geetanjali Medical College and Hospital, in Udaipur, Rajasthan. Inclusion criteria were all the patients who were admitted in the nephrology department and were above 18 y, who were receiving antibiotics, and Creatine Clearance (CrCl) was ≤ 60 ml/min were included into this study. Exclusion criteria patients with renal replacement and lacking information of laboratory data (WBC, CrCl) and those who were below the age of 18 were excluded from the study. The data were analysed using descriptive analysis.
Results: The mean age of the CKD patients was 50.10 (standard deviation=17.47) y. Males were found in greater numbers than that of females with 66 (58%) and 49(42%) respectively. Patients admitted with stage 5 CKD (66%) were greater than the patients with stage 4 CKD. 10 different types of antibiotics were provided to CKD patients, of which seven had irrational doses. Piptaz, Meropenem, and Teicoplanin have the highest irrational doses incidence.
Conclusion: Patients with CKD Stages 4 and 5 were given systemic antibiotics at unreasonable dosages, most frequently in the forms of piptaz, aztreonam, and meropenem injections. The incidence of irrational antibiotic dosages provided to the CKD patients was still high.
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Andrew S Levey, Josef Coresh, Ethan Balk. National kidney foundation practice guidelines for chronic kidney disease: evaluation classification and stratification. Ann Intern Med. 2003 Jul 15;139(2):137-47. doi: 10.7326/0003-4819-139-2-200307150-00013, PMID 12859163.
Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: third national health and nutrition examination survey. Am J Kidney Dis. 2003 Jan;41(1):1-12. doi: 10.1053/AJKD.2003.50007, PMID 12500213.
Barsoum RS. Chronic kidney disease in the developing world. N Engl J Med. 2006 Mar;354(10):997-9. doi: 10.1056/NEJMp058318, PMID 16525136.
Hwang SJ, Tsai JC, Chen HC. Epidemiology impact and preventive care of chronic kidney disease in Taiwan. Nephrology. 2010;15Suppl 2:3-9. doi: 10.1111/j.1440-1797.2010.01304.x, PMID 20586940.
Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM. A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. Kidney Int. 2013 Nov;84(5):1034-40. doi: 10.1038/KI.2013.220, PMID 23760287.
Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end stage renal disease compared with the general population. Kidney Int. 2000;58(4):1758-64. doi: 10.1111/j.1523-1755.2000.00337.x, PMID 11012910.
Restinia M, Lucida H, S WG. A study on clinical assessment of antibiotic used in chronic kidney disease patients. J Ilmu Kefarmasian Indones. 2017;15(2). doi: 10.35814/jifi.v15i2.521.
Ishani A, Collins AJ, Herzog CA, Foley RN. Septicemia access and cardiovascular disease in dialysis patients: the USRDS wave 2 study. Kidney Int. 2005;68(1):311-8. doi: 10.1111/j.1523-1755.2005.00414.x, PMID 15954922.
Ahmed M, Kumar P, DV K, Kumar P, Kauser R, Ali M. Rationale of antibiotic prescription in patients visiting a Tertiary Care South Indian Hospital. Asian J Pharm Clin Res. 2021 Dec;14(12):27-30. doi: 10.22159/ajpcr.2021.v14i12.36082.
Al Aloul M, Miller H, Alapati S, Stockton PA, Ledson MJ, Walshaw MJ. Renal impairment in cystic fibrosis patients due to repeated intravenous aminoglycoside use. Pediatr Pulmonol. 2005 Jan;39(1):15-20. doi: 10.1002/PPUL.20138, PMID 15521084.
Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW. National kidney foundation practice guidelines for chronic kidney disease: evaluation classification and stratification. Ann Intern Med. 2003 Jul 15;139(2):137-47. doi: 10.7326/0003-4819-139-2-200307150-00013, PMID 12859163.
Long CL, Raebel MA, Price DW, Magid DJ. Compliance with dosing guidelines in patients with chronic kidney disease. Ann Pharmacother. 2004 May;38(5):853-8. doi: 10.1345/aph.1D399, PMID 15054147.
Manley HJ, Cannella CA, Bailie GR, St Peter WL. Medication-related problems in ambulatory hemodialysis patients: a pooled analysis. Am J Kidney Dis. 2005 Oct;46(4):669-80. doi: 10.1053/j.ajkd.2005.07.001, PMID 16183422.
Munar MY, Singh H. Drug dosing adjustments in patients with chronic kidney disease. Am Fam Physician. 2007 May;75(10):1487-96. PMID 17555141.
Dalrymple LS, GO AS. Epidemiology of acute infections among patients with chronic kidney disease. Clin J Am Soc Nephrol. 2008 Sep;3(5):1487-93. doi: 10.2215/CJN.01290308, PMID 18650409.
Stemer G, Lemmens Gruber R. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review. BMC Nephrol. 2011 Jul 22;12:35. doi: 10.1186/1471-2369-12-35, PMID 21777480.
Medscape registration. Medscape. Available from: https://emedicine.com/article/238798-overview?form=fpf [Last accessed on 15 Jul 2024].
Lueangarun S, Leelarasamee A. Impact of inappropriate empiric antimicrobial therapy on mortality of septic patients with bacteremia: a retrospective study. Interdiscip Perspect Infect Dis. 2012;2012:765205. doi: 10.1155/2012/765205, PMID 22919379.
Cavanaugh KL. Diabetes management issues for patients with chronic kidney disease. Clin Diabetes. 2007 Jul;25(3):90-7. doi: 10.2337/diaclin.25.3.90.
Steigerwalt S. Management of hypertension in diabetic patients with chronic kidney disease. Diabetes Spec. 2008 Jan;21(1):30-6. doi: 10.2337/diaspect.21.1.30.
Ali A, Kumar P, Ansari JA, Fatima M, Irrum F. A prospective observational study on medication use pattern in patients with risk factors of chronic kidney disease. Asian J Pharm Clin Res. 2021 Dec;14:144-8. doi: 10.22159/ajpcr.2021.v14i12.43513.
Kumar A, Ellis P, Arabi Y, Roberts D, Light B, Parrillo JE. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest. 2009 Nov;136(5):1237-48. doi: 10.1378/CHEST.09-0087, PMID 19696123.
Leung E, Weil DE, Raviglione M, Nakatani H. The WHO policy package to combat antimicrobial resistance. Bull World Health Organ. 2011 May;89(5):390-2. doi: 10.2471/BLT.11.088435, PMID 21556308.
Laing RO, Hogerzeil HV, Ross Degnan D. Ten recommendations to improve use of medicines in developing countries. Health Policy Plan. 2001;16(1):13-20. doi: 10.1093/HEAPOL/16.1.13, PMID 11238425.
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