Đánh giá việc hiệu chỉnh liều kháng sinh ở bệnh nhân suy thận tại Bệnh viện Quân y 7

Renal impairment poses significant challenges in pharmacotherapy due to altered drug pharmacokinetics and pharmacodynamics, leading to potential drug accumulation, toxicity, and reduced efficacy. Antibiotics, frequently used in this vulnerable patient population, require precise dose adjustment to optimize therapeutic outcomes and minimize adverse effects. Despite established guidelines, inappropriate antibiotic prescribing in patients with renal failure remains a global concern. This study addresses a critical gap by evaluating the current status of antibiotic dose adjustment practices at 7 Military Hospital, aiming to identify the prevalence of inappropriate dosing and associated factors to inform targeted interventions and enhance patient safety.

Healthcare professionals, including physicians, clinical pharmacists, nephrologists, infectious disease specialists, and hospital administrators involved in patient care and drug policy development.

This retrospective cross-sectional study assessed antibiotic dose adjustment practices in 269 patients with renal impairment at 7 Military Hospital. The study population was predominantly elderly (mean age 72.7 ± 12.3 years, 85.9% ≥ 60 years) and male (75.8%), with a high proportion exhibiting advanced renal impairment, including acute renal failure (18.2%), stage 3 (39.4%), and end-stage (42.4%). The findings revealed a substantial need for antibiotic dose adjustment, with 60.4% of prescriptions requiring adjustment per G1 guidelines, 23.5% per G2, and 37.2% per G3. Critically, the rates of inappropriate prescription were alarmingly high: 33.0% (G1), 37.6% (G2), and 31.9% (G3). Cefoperazon + Sulbactam, Levofloxacin, and Ciprofloxacin were identified as the antibiotics with the highest frequencies of inappropriate dosing. Statistical analysis further indicated that the number of antibiotics used per treatment course, female gender, and lower glomerular filtration rate (GFR) were significant factors associated with an increased risk of inappropriate dose adjustment. These results underscore the urgent necessity for developing specialized institutional guidelines and fostering consensus among medical and clinical pharmacy professionals to ensure appropriate antibiotic dose adjustment. Implementing these measures is crucial for improving treatment efficacy, reducing adverse drug reactions, and minimizing complications in patients with renal impairment.