Introduction:
Antimicrobials are commonly prescribed to hospitalized CKD patients. Studies showed that antibiotic dose was adjusted in 40 – 62% prescriptions in CKD patients. Dose adjustment according to eGFR can reduce toxicity in these patients. It can also save extra cost due to excessive dosing. There is limited data regarding drug dose errors in CKD from developing countries.
Aim:
Aim of the study was to evaluate the extent of dose adjustment according to eGFR in CKD patients at our institute. We also looked for adverse effects related to excessive doses in patients.
Materials and Methods:
The study was conducted from July 2020 to March 2022. The study cohort comprised of 254 CKD patients admitted in various department and nephrology department was consulted . Investigators screened the records of patients. Patients were included in study on basis of inclusion and exclusion criteria. Descriptive statistics was used to present the results.
Results:
Patients received total 626 antimicrobials with mean of 2.46 per patient. About 539 antimicrobial drugs needed modification of doses but no adjustment was done in 55.28% prescriptions. Beta lactum antibiotics were most prescribed antibiotics. Only 51 % of patients received appropriate dose in beta lactum group. Amoxicillin clavulanate dosage were inappropriate in 75.28% patients followed by cefepime (57.4%), ceftizoxime (44.82%) and Piperacillin tazobactam (31.7%). Most patients (86.66%) on colistin received inappropriate doses. Patients on vancomycin and amikacin also received inappropriate dose adjustments in ˃ 65% patients. Fluconazole dose was adjusted in 61.8% cases while only 14% patients received adjusted dose of acyclovir. Adverse drug reactions due to inappropriate doses were observed in 19 patients
Conclusion:
We found drug dose errors of antimicrobials in 55% cases. Antibiotic dose adjustment had been observed 40-60% in different studies. It would be appropriate to increase awareness about dose adjustment in CKD patients among physicians.
Key words: Antibiotic doses, renal failure, dose adjustment
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