Pharmacists’ Knowledge About the Impact of Augmented Renal Clearance on Antimicrobial Dosing in Critically Ill Patients: A Cross-Sectional Study

Almulhim, Abdulaziz; Al-Dahneen, Batool A.; Alsowaida, Yazed Saleh

doi:10.1007/s40121-020-00310-9

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…30,31 This may lead to augmented renal clearance (ARC) of drugs from the circulation, thereby lowering the circulating concentration more rapidly than would occur in noncritically ill patients. 32,33 Human studies 17 have demonstrated ARC in approximately half of critically ill patients requiring antimicrobial therapy. Those patients with ARC also showed a greater rate of treatment failure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the pharmacokinetics of continuous and intermittent infusions of ampicillin-sulbactam in dogs with septic peritonitis

Stewart¹,

Allen²,

Eisenberg³

et al. 2022

ajvr

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OBJECTIVE To evaluate the time-course of ampicillin-sulbactam and percentage of time that its concentration is above a given MIC (T% > MIC) in dogs with septic peritonitis when delivered as either a continuous infusion (CI) or intermittent infusion (II). ANIMALS 11 dogs with septic peritonitis. PROCEDURES Dogs were randomized to receive ampicillin-sulbactam as either CI or II. Continuous infusions were delivered as a 50 mg/kg bolus IV followed by a rate of 0.1 mg/kg/min. Intermittent infusions were administered as 50 mg/kg IV q8h. Serum ampicillin-sulbactam concentrations were measured at hours 0, 1, 6, and every 12 hours after until patients were transitioned to an oral antimicrobial equivalent. All other care was at the discretion of the attending clinician. Statistical analysis was used to determine each patient's percentage of time T% > MIC for 4 MIC breakpoints (0.25, 1.25, 8, and 16 µg/mL). RESULTS No dogs experienced adverse events related to ampicillin-sulbactam administration. Both CI and II maintained a T% > MIC of 100% of MIC 0.25 µg/mL and MIC 1.25 µg/mL. The CI group maintained a higher T% > MIC for MIC 8 µg/mL and MIC 16 µg/mL; however, these differences did not reach statistical significance (P = .15 and P = .12, respectively). CLINICAL RELEVANCE This study could not demonstrate that ampicillin-sulbactam CI maintains a greater T% > MIC in dogs with septic peritonitis than II; however, marginal differences were noted at higher antimicrobial breakpoints. While these data support the use of antimicrobial CI in septic and critically ill patients, additional prospective trials are needed to fully define the optimal doses and the associated clinical responses.

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Section: Discussionmentioning

confidence: 99%

Comparison of the pharmacokinetics of continuous and intermittent infusions of ampicillin-sulbactam in dogs with septic peritonitis

Stewart¹,

Allen²,

Eisenberg³

et al. 2022

ajvr

View full text Add to dashboard Cite

show abstract

“…This was a cross-sectional study. Data were collected as previously described in Almulhim, Al-Dahneen & Alsowaida (2020) . In short, an electronic link was sent to three scientific organizations: Saudi Pharmaceutical Society (SPS), Kuwait Pharmaceutical Association (KuPhA), and Oman Pharmaceutical Society (OmPhS).…”

Section: Methodsmentioning

confidence: 99%

Evaluating pharmacists’ knowledge, attitude, and practices toward amiodarone cross-reactivity with iodine: a cross-sectional pilot study

Alshehab¹,

Alhumaid²,

Alabdulwahed³

et al. 2022

PeerJ

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Introduction Iodine is a vital mineral of the human body that acts by maintaining the health of the thyroid gland. Research has shown that iodine-rich food allergy (i.e., seafood allergy) is not caused by iodine itself; instead, it is caused by other proteins including tropomyosin and parvalbumin in shellfish and fish, respectively. Amiodarone is a commonly used antiarrhythmic agent containing a significant amount of iodine. Objective This study’s objective was to assess pharmacists’ knowledge, attitude, and practices toward the misconception of iodine allergy and the cross-reactivity with amiodarone. Methods In February 2020, a cross-sectional study was conducted by sending out an online survey to three pharmaceutical organizations (Saudi Pharmaceutical Society, Kuwait Pharmaceutical Association, and Oman Pharmaceutical Society). Additionally, an electronic questionnaire was administered to pharmacists attending the Dubai International Pharmaceuticals and Technologies Conference and Exhibition 2020 (DUPHAT). Chi-square or Fisher’s exact test, when appropriate, were used to compare categorical variables. The statistical analyses were carried out using SPSS software. Results Data were collected from 66 respondents. However, only 61 (92.4%) were included in the final analysis following the exclusion of incomplete responses. The mean age of participants was 35 ± 8.48 years. The majority of participants did not have the Board of Pharmacy Specialties Certification (54.1%). Moreover, (41%) of participants licensed as pharmacists with more than 10 years of initial pharmacy licensure. Forty-three (70.5%) of participants had the misconception that iodine allergy should be considered before amiodarone administration, 20/32 (62.5%) of whom considered iodine allergy alone thought that premedication with corticosteroids and/or antihistamines is necessary. Concerning iodine allergy and amiodarone use, there was no significant difference in knowledge between the pharmacists who have board certification and those who did not. Conclusion Pharmacists’ misconception concerning iodine allergy and cross-reactivity with amiodarone was evident. Implementation of educational programs targeting pharmacists is necessary to correct these misconceptions.

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Pharmacists’ Knowledge About the Impact of Augmented Renal Clearance on Antimicrobial Dosing in Critically Ill Patients: A Cross-Sectional Study

Cited by 2 publications

References 27 publications

Comparison of the pharmacokinetics of continuous and intermittent infusions of ampicillin-sulbactam in dogs with septic peritonitis

Comparison of the pharmacokinetics of continuous and intermittent infusions of ampicillin-sulbactam in dogs with septic peritonitis

Evaluating pharmacists’ knowledge, attitude, and practices toward amiodarone cross-reactivity with iodine: a cross-sectional pilot study

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