Is antibiotic dosing appropriate for renal function in older adults？

• 作者: EdwardP.Norkus MarilouCorpuz RanganathanRajendran T.S.Dharmarajan
• 来源期刊: 世界今日医学杂志
• 学科: 医学
• 关键词: 抗生素 用药剂量 老年 肾脏功能
• 年，卷（期）: 2000,（5）
• 页码范围: 441-444
• 页数: 4页
• 分类号: R977.2

摘要

A retrospective observational study was used to detennine if antibiotic dosing practices in older adults were adjusted for age or disease related changes in renal function in 196 patients, 17 to 99 years, hospitalized for urosepsis or pneumonia. Appropriate or inappropriate antibiotic dosing, based on ereatinine clearance, was assessed in three groups categorized by age and renal function. Duration of antibiotic therapy (iv, oral and total) was statistically equivalent across the three age groups. Older patients had significantly higher serum BUN (P<0.0000), creatinine (P=0.0078), renal impairment (P<0.000), and hospital deaths (P<0.000) compared to the young. Older adults were prescribed inappropriately higher antibiotic dosages significantly more often (P<0.000) than the young. The very old, prescribed excessive antibiotic doses (P=0.005) not adjusted for renal status, had an increased rate of Clostridium difficile colitis infection (P=0.014). In conclusion, excessive antibiotic dosing, not adjusted for ereatinine clearance, occurs in the elderly and we believe that it is correctable.