Resumen de Intervención farmacéutica en pacientes con insuficiencia renal: Ajuste posológico de antibióticos
M. Merchante Andreu, Mª Fe Hurtado Gómez, Carlos Sainz de Rozas Aparicio, María Teresa Barajas Santos
Objective: To make a dose adjustment for patients with serum creatinine (SCr) > 1.5 mg/dl under antibiotic treatment, and describe the required pharmaceutical interventions (PI). Method: Prospective study performed in an 800-bed general hospital for seven months. The population is encompassed by inpatients with SCr > 1.5 mg/dl and under treatment with antibiotics. For each patient, we have recorded demographic data, renal function (estimated glomerular filtration by the MDRD4 formula), antibiotic treatment, recommended dose adjustment and pharmaceutical intervention. Results: In the period of study, we have identijied 510 patients with SCr > 1.5 mg/dl with a total 514 antibiotic prescriptions. 241 dose adjustments were needed, out of which 136 (56.4%) were accepted. Levofloxacin and amoxicillin/clavulanate were the drugs that required the greater number of PI. By clinical services, Internal Medicine and Geriatrics are the ones that stand out. General Surgery showed the greatest percentage of acceptance. The most frequent PI was dosage reduction, followed by the increase of dose interval. Conclusion: Pharmaceutical interventions had for the most part a high degree of acceptance. We consider as necessary establishing a working protocol that allows for detecting and intervening on those cases where there exist inadequate directives for the patients' renal situation
