Dosing regimen for antimicrobial agents with anti MRSA activity in patients receiving continuous veno-venous hemodiafiltration under low-dose setting

Abstract

Continuous renal replacement therapy (CRRT) is now commonly used as a mean of support for critically ill patients with renal failure. In Japan, CRRT is also performed to remove several inflammatory mediators that have detrimental effects in septic shock. Key aspects of PK like antibiotic clearance (CL) and volume of distribution are altered in critically ill patients with acute kidney injury. Extracorporeal CL during CRRT is mainly influenced by the properties of the antibiotics and the dose of dialysate and filtrate (CRRT dose). Continuous renal replacement procedures vary depending on the country. In general, the CRRT dose in Japan is lower than the setting in USA, UK, and Australia. Using post hoc analysis of our data in vancomycin, teicoplanin, daptomycin and linezolid, this topic aims to describe the current clinical scenario for design of antimicrobial agents with anti-methicillin-resistant Staphylococcus aureus(MRSA) activity dosing in critically ill patients with sepsis/septic shock undergoing continuous veno-venous hemodiafiltration under low-dose setting which is adopted in Japan.