Concept to monitoring of antimicrobial agents with continuous renal replacement therapy

Abstract

Continuous renal replacement therapy (CRRT) for acute kidney injury and sepsis is used to replace renal function and eliminate cytokines. CRRT may cause changes in drug pharmacokinetics. Since antimicrobial agents are often administered when CRRT is performed, an administration based on pharmacokinetics/pharmacodynamics (PK/PD) theory is required from the viewpoint of efficacy, safety, and antimicrobial resistance. When planning the dose based on PK/PD theory, it is important to understand basic pharmacokinetic parameters, clearance, and volume of distribution. In this review, we outline the pharmacokinetic characteristics and changes of antimicrobial agents during CRRT and explain the concept of dosage adjustment and therapeutic drug monitoring based on the cases experienced at our hospital.