Colistin의 용량 적절성 평가 및 제언
The Evaluation of Dose Adjustment of Colistin and Proposal
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Colistin was used for only external application due to its nephrotoxicity and neurotoxicity when it was administered for IV route is increased because Multidrug resistant (MDR) microorganisms is increased in 2000s. The dosage for Colistin has to be adjusted according to Serum Creatinine (Scr) level, which indicates renal function failure. However, Scr has many other factors that influence its level to limit renal function failure. We evaluated the dose adjustment according to Scr and Creatinine clearance (CLcr), and compared the outcomes and adverse drug reactions, in order to consider new renal dosing. This study retrospectively reviewed the medical records of adult patients of more than 19 years old admitted to SNUH from July 2008 to July 2010, who had been treated with Colistin for more than continuous 4 days, and excluded patients with renal replacement therapy (HD/CRRT). A total of 74 patients, out of 159 Scr cases were evaluated. Appropriate rate of Scr criteria was 45.9%, and appropriate rate of CLcr criteria was 35.8%. In addition, there were lower nephrotoxicity expression rate when the right dose were used, according to CLcr criteria. For the normal renal function group Scr≤1.3mg/dL, CLcr≥90mL/min, it is considered that dose adjustment according to CLcr criteria is more reasonable than that of Scr criteria.
Abstract
Colistin was used for only external application due to its nephrotoxicity and neurotoxicity when it was administered for IV route is increased because Multidrug resistant (MDR) microorganisms is increased in 2000s. The dosage for Colistin has to be adjusted according to Serum Creatinine (Scr) level, which indicates renal function failure. However, Scr has many other factors that influence its level to limit renal function failure. We evaluated the dose adjustment according to Scr and Creatinine clearance (CLcr), and compared the outcomes and adverse drug reactions, in order to consider new renal dosing. This study retrospectively reviewed the medical records of adult patients of more than 19 years old admitted to SNUH from July 2008 to July 2010, who had been treated with Colistin for more than continuous 4 days, and excluded patients with renal replacement therapy (HD/CRRT). A total of 74 patients, out of 159 Scr cases were evaluated. Appropriate rate of Scr criteria was 45.9%, and appropriate rate of CLcr criteria was 35.8%. In addition, there were lower nephrotoxicity expression rate when the right dose were used, according to CLcr criteria. For the normal renal function group Scr≤1.3mg/dL, CLcr≥90mL/min, it is considered that dose adjustment according to CLcr criteria is more reasonable than that of Scr criteria.
참고문헌 (15)
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