A Study on Clinical Assessment of Antibiotic Used in Chronic Kidney Disease Patients

  • Mita Restinia UNIVERSITAS PANCASILA
  • Henny Lucida UNIVERSITAS ANDALAS
  • Wasif Gillani S SCHOOL OF PHARMACEUTICAL SCIENCE, USM MALAYSIA

Abstract

A 6-week longitudinal prospective study was conducted to assess the effectiveness and the safety antibiotic used in chronic kidney disease (CKD) patients in internal medicine ward. We compared white blood count and glomerular fi ltration rate before and after antibiotic used. The CKD patients who admitted in the internal medicine ward and age ≥18 years old were included this study. Patients with incomplete laboratory data and renal replacement therapy were excluded in this study. The 25 patients who enrolled in this study were recruited. The majority gender of CKD was male (64%), the mean of age was 61.52±14.17 years old with length of stay (LOS) was 6.92±4.05 days. The highest number of patients was in CKD stage 3 (n=10, 40%) and was followed by CKD stage 2 (n=6, 24%). Most of them were diagnosed community acquired pneumonia. Tablet azithromycin (n=16, 64%) then Cefotaxime intra venous injection (IV) (n= 6, 24%), and Ceftazidime IV (n=5, 20%), Cloxacillin IV (n=4, 16%) were the most antibiotics prescribed. Generally patients had been prescribed appropriate dose of antibiotic and 88% of them showed improved white blood count. In contrast, the glomerular fi ltration rate of 44% CKD patients was getting worse. In conclusion, this study clearly indicate the CKD patients require close monitoring to maintenance of renal function even the antibiotic had been prescribed appropriately.

References

1. National Kidney Foundation.Clinical practice guideline for chronic kidney disease: evaluation, classifi cation and stratifi cation. Am J Kidney Dis 2002.39:S1-266.

2. Hwang SJ, Tsai JC, Chen HC. Epidemiology, impact and preventive care of chronic kidney disease in Taiwan. Nephrology. 2010.15(2):3-9.

3. Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM, Mohamud WN, Yusoff MF. A population-based study measuring the prevalence of chronic kidney disease among adult in West Malaysia. Kidney Int. 2013.84(5):1034- 40. Doi:10.1038/ki.2013.220.Epub 2013 Jun 12.

4. United States Renal Data System. USRDS 2007. Annual data report.

5. Naqvi SB, Collins AJ. Infectious complication in chronic kidney disease. Adv Chronic Kidney Dis. 2006.13:199-204.

6. McDonald HI, Thomas SL, Nitsch D. Chronic kidney disease as a risk factor for acute communityacquired infection in high-income countries: a systematic review. BMJ Open. 2014.4:1-12. doi:10.1136/bmjopen-2013-004100.

7. Al-Loul M, Miller H,Alapati S, Stockton PA, Ledson MJ, Walshaw MJ. Renal impairment in cystic fi brosis patients due to repeated intravenous aminoglycoside use. Wiley online library. 2005.39(1):217-20.

8. Munar MY, Singh H. Drug dosing adjustments in patients with chronic kidney disease. American Family Physician. 2007.75(10):1487-96. 9. Dalrymple LS, Go AS. Epidemiology of acute infections among patients with chronic kidney disease. CJASN. 2008.3(5):1487-93. Doi:10.2215/ CJN.01290308.

10. Yang P, Chen N, Wang RR, Li L, Jiang SP. Inappropriateness of medication prescriptions about chronic kidney disease patients without dialysis therapy in a Chinese tertiary teaching hospital. Therapeutic and Clinical Risk Management. 2016.12:1517-24. 11. Farag A, Garg AX, Li L, Jain AK. Dosing errors in prescribed antibiotics for older persons with CKD: a retrospective time series analysis. Am J Kidney Dis. 2014.63(3):422-8.

12. Li P, Li F-j, Liu Y-g. Rationality antibiotic use in patients with chronic renal insuffi ciency. Eval Anal Drug-Use Hosp China. 2012.12(5):425-7.13. United States Renal Data System. USRDS 2015. Annual data report: CKD in the United State volume 1. 2015.

14. Aronow WS, Fleg JL, Pepine JC, Artinian NT, Bakris G, Brown AS, et.al. ACCF/AHA 2011 expert consensus document o hypertension in the elderly: A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Document developed in collaboration with the American Academy of Neurology, American Geriatric society, American society for preventive cardiology, American Society of Hypertention, American Society of Nephrology, Association of Black Cardiologist, and European Society of Hypertention. J am Coll Cardiol. 2011.57:2037-114.

15. Lutfiyya N, Henley E, Chang LF, Reyburn SW. Diagnosis and treatment of communityacquired pneumonia. American Family Physician. 2006.73(3):442-50.

16. Santra S, Agrawal D, Kumar S, Mishra SS. A study on the drug utilization pattern in patients with chronic kidney disease with emphasis on antibiotics. Journal of integrative nephrology and andrology. 2015. 2(3): 85-9.

17. WenyuChou L, Che-Yi MD, Shu-Ming W MD, Chih-Chia MD, Ching Tzung MD, Jiung-Hsiun MD, et.al. Risk of pneumonia among patients with chronic kidney disease in outpatients and inpatient setting: A nationwide population-based study. Medicine. 2014.93(27):p e 174. Doi.10.1097/ MD.0000000000000174.

18. Viasus D, Garcia-Vidal C, Cruzado JM, Adamuz J, Adamuz J, Verdagur , Manresa F, Dorca J, Gudiol F, Carratal J. Epidemiology, clinical, features and outcome of pneumonia in patients with chronic kidney disease. Nephrol Dial Transplant. 2011.26:2899-906. doi.10.1093/ndt/gfq798.

19. Cavanaugh KL. Diabetes management issues for patients with chronic kidney disease. Clinical Diabetes. 2007.25(3):90-7.

20. Steigerwalt S. Management of hypertension in diabetic patients with chronic kidney diasease. Diabetes Spectrum. 2008. 21(1):30-6.

21. KDOQINational Kidney Foundation: KDOQI clinical practice guideline recommendation for anemia in chronic kidney disease. Am J Kidneys. 2006.47(3):11-145.

22. Baitt JL, Lin HY. Mechanism of anemia in CKD. JASN. 2012.23(10):1631-4. Doi.10.1681/ ASN.2011111078.

23. National Antibiotic Guideline. National Antibiotic Guideline. Malaysia: Ministry of Health Malaysia; 2008.

24. Thawani V, Kunda G, & Paranjpe BF. Antibiotics: pharmacoepidemiology of antibiotics, our experience. Regional Health Forum WHO South East Asia Region. 2006. 2(2): 1343.

25. Livornese LL Jr, Gilbert B, Robbins P, Santoro J.Use of antimibacterial agents in renal failure. Infect Dis Clin North Am. 2004.18:556-67.
Published
2017-09-30
How to Cite
RESTINIA, Mita; LUCIDA, Henny; S, Wasif Gillani. A Study on Clinical Assessment of Antibiotic Used in Chronic Kidney Disease Patients. JURNAL ILMU KEFARMASIAN INDONESIA, [S.l.], v. 15, n. 2, p. 203-209, sep. 2017. ISSN 2614-6495. Available at: <http://jifi.farmasi.univpancasila.ac.id/index.php/jifi/article/view/521>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.35814/jifi.v15i2.521.
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Articles