Abstract
Many anti-infective drugs require dose adjustments in critically ill patients with acute kidney injury (AKI) and renal replacement therapy, in order to achieve adequate therapeutic drug concentrations. The fundamental pharmacokinetic and pharmacodynamic principles of drug dose adjustment are presented. Recommendations on anti-infective drug dosage in intensive care are provided. We established dose recommendations of selected anti-infective drugs based on information in the summary of product characteristics, published studies and recommendations, pharmacokinetic and pharmacodynamic considerations, and the experience and expert opinion of the authors. Out of atotal of 37anti-infective drugs (31antibiotics, 2antivirals, 4antifungals) 8can be administered independent of renal function. For 29anti-infective drugs, aspecific recommendation on drug dosage could be made in case of intermittent hemodialysis and for 24anti-infective drugs in case of continuous hemo(dia)filtration. Recommendations on dosing of important anti-infective drugs in critically ill patients with AKI and renal replacement therapy are provided.
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