Antibiotic Dosing in Slow Extended Daily Dialysis

Slow extended daily dialysis (SLEDD) is the newest form of dialysis that is being used increasingly to replace continuous venovenous hemodialysis (CVVHD) for critically ill patients; it is less expensive to administer and has similar safety for patients who are prone to hemodynamic instability. Unfo...

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Bibliographic Details
Published in:Clinical infectious diseases 2009-08, Vol.49 (3), p.433-437
Main Authors: Goldstein, Ellie J. C., Mushatt, David M., Mihm, Linda B., Dreisbach, Albert W., Simon, Eric E.
Format: Article
Language:English
Subjects:
Acute kidney failure
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - pharmacokinetics
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antimicrobials
Bacterial Infections - drug therapy
Biological and medical sciences
Blood flow
Clinical Practice
Critical Illness
Dialysis
Dialysis - methods
Dialysis solutions
Dosage
Flow velocity
Hemodialysis
Humans
Infectious diseases
Intensive care units
Medical sciences
Patient safety
Pharmacokinetics
Pharmacology. Drug treatments
Renal Insufficiency - therapy
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Summary:Slow extended daily dialysis (SLEDD) is the newest form of dialysis that is being used increasingly to replace continuous venovenous hemodialysis (CVVHD) for critically ill patients; it is less expensive to administer and has similar safety for patients who are prone to hemodynamic instability. Unfortunately, there are limited data regarding the appropriate dosing of antimicrobial agents for patients undergoing SLEDD. Furthermore, many nonnephrologists are not familiar with the differences between SLEDD, other continuous renal replacement therapies—for example, CVVHD—and routine hemodialysis. Thus, there is potential for inaccurate and, at worst, inadequate dosing of critical antimicrobial agents for this patient population. We review the available pharmacokinetic data on SLEDD and give preliminary recommendations for how to approach dosing in this situation.
ISSN:1058-4838
1537-6591
DOI:10.1086/600390