Severity: Warning
Message: file_get_contents(https://...@gmail.com&api_key=61f08fa0b96a73de8c900d749fcb997acc09): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 143
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 143
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 209
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 994
Function: getPubMedXML
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3134
Function: GetPubMedArticleOutput_2016
File: /var/www/html/application/controllers/Detail.php
Line: 574
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 488
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Background: Most antibiotics require dose adjustments in patients with chronic kidney disease (CKD) to avoid accumulation and toxicity. The aim was to characterize the use of systemic antibiotics in a group of patients with CKD and to adjust the dose according to the glomerular filtration rate (GFR).
Research Design And Methods: Observational study of patients with a diagnosis of CKD who received antibiotics between January-2021 July 2022. The Lexicomp® database was used to determine the dose adjustment according to the GFR.
Results: A total of 473 patients were included, average age of 72.6 years. Patients with CKD were in stage 3 (38.5%), stage 4 (23.5%), or stage 5 (38.1%). Cephalosporins (56.2%), penicillins (43.3%), and glycopeptides (20.3%) were the most widely used antibiotics. A total of 914 antibiotics were used, of which 39.5% did not require dose adjustment, 30.4% had no dose adjustment, and 30.1% had dose adjustment. Treatment with glycopeptides (adjusted Odds Ratio [aOR]:3.86; 95%CI:1.57-9.47), treatment with carbapenems (aOR:4.59; 95%CI:1.75-12.07), stage-4 CKD (aOR:31.61; 95%CI:9.77-102.29), and stage-5 CKD (aOR:21.29; 95%CI:3.66-123.61) increased the probability of receiving antibiotics without dose adjustment according to the GFR.
Conclusions: Almost one-third of the antibiotics used in this group of patients had no dose adjustment, which generates a significant risk of toxicity and the need to identify CKD in a timely manner and the appropriate use of antibiotics.
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Source |
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http://dx.doi.org/10.1080/14740338.2024.2443780 | DOI Listing |
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