{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:54:31Z","timestamp":1791237271635,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,4]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Acute kidney injury (AKI) is a potential complication of systemic infection. Optimizing antimicrobial dosing in this dynamic state can be challenging with sub- or supra-therapeutic dosing risking treatment failure or toxicity, respectively. Locally, unadjusted renal dosing for the first 48\u2005h of infection is recommended.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To determine the outcomes associated with this dosing strategy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort analysis was undertaken in patients treated for Gram-negative bacteraemia with concurrent non-filtration dependent AKI from a single-centre NHS acute hospital (April 2016\u2013March 2020). Patient demographics, microbiology data, antimicrobial treatment and patient outcome (in-hospital mortality and kidney function) were analysed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In total, 647 episodes of Gram-negative bacteraemia (608 patients) were included; 305\/608 (50.2%) were male with median age 71\u2005years (range 18\u2013100). AKI was present in 235\/647 (36.3%); 78\/647 (12.1%) and 45\/647 (7.0%) having Kidney Disease Improving Global Outcomes-defined injury (stage 2) or failure (stage 3), respectively. In-hospital 30\u2005day mortality was 25\/352 (7.1%), 14\/112 (12.5%), 26\/123 (21.1%) and 11\/60(18.3%) in patients with normal renal function, AKI stage 1, AKI stage \u22652 and established chronic kidney disease, respectively. Recovery of renal function at Day 21 or discharge was present in 105\/106 surviving patients presenting with AKI stage \u22652. Time to recovery of AKI was similar in patients receiving full, low or no aminoglycoside (3 versus 4 versus 3\u2005days, P\u200a=\u200a0.612) and those receiving full- and low-dose \u03b2-lactam (3 versus 5\u2005days, P\u200a=\u200a0.077).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n There is a high burden of AKI in patients with Gram-negative bacteraemia. Dose adjustments of \u03b2-lactams may not be necessary in the first 48\u2005h of infection-induced AKI and single-dose aminoglycosides may be considered for early empirical coverage.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jacamr\/dlac080","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T17:09:24Z","timestamp":1658768964000},"source":"Crossref","is-referenced-by-count":12,"title":["Optimization of antimicrobial dosing in patients with acute kidney injury: a single-centre observational study"],"prefix":"10.1093","volume":"4","author":[{"given":"Stephen","family":"Hughes","sequence":"first","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust , 369 Fulham Road, London SW10 9NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie L","family":"Heard","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust , 369 Fulham Road, London SW10 9NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeela","family":"Mughal","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust , 369 Fulham Road, London SW10 9NH , UK"},{"name":"North West London Pathology, Imperial College Healthcare NHS Trust , Fulham Palace Road, London W6 8RF , UK"},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus , Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7095-7922","authenticated-orcid":false,"given":"Luke S P","family":"Moore","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust , 369 Fulham Road, London SW10 9NH , UK"},{"name":"North West London Pathology, Imperial College Healthcare NHS Trust , Fulham Palace Road, London W6 8RF , UK"},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus , Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"2022072517091514100_dlac080-B1","doi-asserted-by":"crossref","first-page":"l525","DOI":"10.1136\/bmj.l525","article-title":"Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study","volume":"364","author":"Gharbi","year":"2019","journal-title":"BMJ"},{"key":"2022072517091514100_dlac080-B2","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s00134-008-1367-2","article-title":"Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to 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