Magnitude and Factors Associated with Augmented Renal Clearance and Practice of Antimicrobial Prescription in Pediatric Intensive Care Units Among Children Admitted to TASHand Alert Center
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Date
2024-12-04
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Addis Ababa University
Abstract
Augmented renal clearance (ARC) refers to a condition where there is an increased elimination of renal solutes, presenting notable challenges in the Pediatric Intensive Care Unit (PICU). This phenomenon can have a significant impact on various aspects of patient care, such as medication dosing, treatment effectiveness, and overall clinical outcomes.
In clinical practice, managing ARC necessitates close monitoring and individualized approaches tailored to each patient's unique renal status. ARC is associated with suboptimal exposure to critical medications, particularly hydrophilic antibiotics including ß-lactams, Vancomycin, Aminoglycosides leading to treatment failure and development of resistance. Mechanisms for ARC in critically ill patients are incompletely defined. Aggressive fluid resuscitation, presence of SIRS, capillary leak, use of vasopressors and inotropes, neuro hormonal changes, activation of renal functional reserve in young individuals lead to increase in renal perfusion and increase in GFR
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Renal Clearance and Practice of Antimicrobial Prescription