Antimicrobials and renal failure in neutropenic patients

Abstract

Antimicrobial treatment is often indicated to neutropenic patients. Although renal failure is a common complication of many antibiotics, no information could be found in the literature defining which are the best screening criteria for detecting renal injury. In this paper, the authors aim to assess the progress to renal failure in neutropenic patients on antimicrobial use and to compare different diagnostic criteria of renal failure in association to antimicrobial agents used. This is a cohort study conducted from February to August 2006 at the Hospital das Clínicas of the Universidade Federal de Minas Gerais, which included patients with neutropenia and antimicrobial therapy for the treatment of Healthcare Associated Infections notified by the Hospital Infection Control Committee. Renal injury has ensued in 25% of patients and no statistical difference between distinct criteria for renal injury was observed. Association of greater number of antimicrobials was associated with renal impairment. Time required for renal injury was independent of the antimicrobial regimen used, but mortality among patients with renal injury was higher when compared to those who had preserved renal function.

An experience with colistin applied in treatment of imunocompromised patients with peritonitis on peritoneal dialysis

“…Most common pathogens include Escherichia coli, Klebsiella, Proteus, more rarely Campylobacter, Citrobacter, Acinetobacter etc. Initial empiric antimicrobial treatment of peritonitis (cephalosporins, vancomycin, aminoglycosides) revealed no clinical improvement, since the isolated Acinetobacter organism was resistant to all tested antibiotics, except colistin 8,15 . Immunocompromised patients are particularly susceptible.…”

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