Commentary

Appropriate antibiotic dosing in severe sepsis and acute renal failure: factors to consider

Francisco J González de Molina¹ and Ricard Ferrer^1,2*

• * Corresponding author: Ricard Ferrer 29421rfr@comb.cat

Author Affiliations

¹ Critical Care Department, Mutua Terrassa University Hospital, University of Barcelona, Plaça Dr. Robert, 5, Terrassa 08221, Barcelona, Spain

² CIBER, Enfermedades Respiratorias, Fundaci d Investigaci Sanit ria de les Illes Balears (FISIB), Recinto Hospital Joan March, Carretera Soller Km 12 07110, Bunyola, Mallorca, Illes Balears

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Critical Care 2011, 15:175 doi:10.1186/cc10298

See related research by Seyler et al., http://ccforum.com/content/15/3/R137

Published: 1 August 2011

Abstract

Severe sepsis and septic shock cause considerable morbidity and mortality. Early appropriate empiric broad-spectrum antibiotics and advanced resuscitation therapy are the cornerstones of treatment for these conditions. In prescribing an antibiotic regimen in septic patients with acute renal failure treated with continuous renal replacement therapy, several factors should be considered: pharmacokinetics, weight, residual renal function, hepatic function, mode of renal replacement therapy (membrane and surface area, sieving coefficient, effluent and dialysate rate, and blood flow rate), severity of illness, microorganism, minimum inhibitory concentration, and others. Studies that determine the serum antibiotic concentrations are very useful in establishing the correct dosage in critical patients.