Concordance between Drug Dosing Recommendations of Antimicrobials Based On Cockcroft-Gault and MDRD Equations In Patients With Chronic Renal Dysfunction
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
The glomerular filtration rate (GFR) is the most precise measure of kidney function, however direct measurement of the GFR is difficult and expensive. With the introduction of the Modification of Diet in Renal Disease (MDRD) equation to calculate GFR in patients with chronic kidney disease, questions arise as to whether this method should be considered over the Cockcroft–Gault (CG) equation when making dosage adjustments for antimicrobials that are renally eliminated. The study was carried out to assess the concordance between drug dosing recommendations of antimicrobials based on Cockcroft-Gault and MDRD equations in patients with chronic renal dysfunction. Study populations of 75 patients were included as per the inclusion criteria. For each antibiotic, the match rate in dosing recommendation was compared with the hypothesized value of 85%. The match rate of amoxicillin/clavulanic acid and ofloxacin was found to be 100%, piperacillin/tazobactam 89.58%, levofloxacin 81.8%, vancomycin 66.6% meropenem 58.3%, and cefuroxime axetil 50%. When comparing doses derived from CG and MDRD equation, no statistically significant difference was seen for piperacillin/tazobactam (p = 0.1825),meropenem(p=0.1661),levofloxacin(P = 0.1669), vancomycin (p = 0.4226) and cefuroxime axetil (p = 0.5000). Overall the CG and MDRD equations rendered the same dose 83.3% of time (p = 0.9849). A positive correlation was found between CG and MDRD equations in the determination of renal function using CrCl and eGFR. However, there was a statistically significant difference existed between these two (p<0.05).
Authors and Affiliations
Dr. Manjula Devi . A. S, Dr. Prof. P. Jambulingam MD, Neha Maria Augustine
Keywords
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