{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:58:17Z","timestamp":1791910697381,"version":"4.3.4"},"reference-count":0,"publisher":"Bentham Science Publishers Ltd.","issue":"2","content-domain":{"domain":["eurekaselect.com"],"crossmark-restriction":true},"short-container-title":["CRCEP"],"published-print":{"date-parts":[[2021,8,3]]},"abstract":"<jats:sec>\n<jats:title>Background:<\/jats:title>\n<jats:p>Critically ill adults have augmented renal clearance, (ARC) decreasing the systemic circulation\nof drugs with predominant renal elimination. The phenomenon of ARC is crucial for antimicrobial drugs as it hinders with\nthe therapeutic response and aids the development of antimicrobial resistance. We carried out the present study to assess\nthe impact of ARC in an intensive care unit (ICU) of a tertiary care hospital.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods:<\/jats:title>\n<jats:p> This was a prospective observational study carried out in critically ill patients with normal serum creatinine\nwithout any history of renal disease. Details on their demographic characteristics, clinical diagnoses, laboratory\nparameters including trough levels of vancomycin and gentamicin, ICU length of stay and clinical outcomes (discharged\nalive\/death) were obtained. Creatinine clearance (Crcl) was estimated from 24-hour urine creatinine. Monte Carlo\nsimulation test with 100000 iterations was used for predicting serum vancomycin trough levels with the observed Crcl.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results:<\/jats:title>\n<jats:p>Eighty patients were recruited in the study of which 52.5% had ARC. Patients in younger\nage and body weight were observed with a trend to have ARC. No significant differences were\nobserved in any of the drug classes prescribed between patients with and without ARC, including\nthe systemic antimicrobials. Although the observed serum trough levels of vancomycin in patients\nwith ARC did not differ significantly from those without ARC, Monte Carlo simulation predicted\nthat 90% of patients with ARC were likely to have trough levels between 5.63 and 7.85 mg\/dl,\nwhile those without ARC may have it between 7.75 to 9.82 mg\/dl.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>A significant proportion of critically ill adults exhibit ARC and such patients are more\nlikely to achieve lower trough concentrations of vancomycin than recommended. All critically ill\nadults with normal serum creatinine have to be screened for ARC using urine creatinine as soon as\npossible for appropriate adjustment in the dosage regimen of antimicrobials with predominant renal\nelimination.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1574884715666200810095225","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T07:41:02Z","timestamp":1597131662000},"page":"174-181","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Drug Utilization in Critically Ill Adults with Augmented Renal Clearance Compared to Normal Renal Clearance: Implications for use of Antimicrobials with Predominant Renal Excretion"],"prefix":"10.2174","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3811-6503","authenticated-orcid":true,"given":"Kannan","family":"Sridharan","sequence":"first","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheikh A.A.","family":"Pasha","sequence":"additional","affiliation":[{"name":"Adult Intensive Care Unit, Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali M.","family":"Qader","sequence":"additional","affiliation":[{"name":"College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan M.S.N.","family":"Hasan","sequence":"additional","affiliation":[{"name":"Adult Intensive Care Unit, Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed M.","family":"ElSeirafi","sequence":"additional","affiliation":[{"name":"Adult Intensive Care Unit, Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","container-title":["Current Reviews in Clinical and Experimental Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/eurekaselect.com\/article\/download\/184713","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.eurekaselect.com\/184713\/article","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eurekaselect.com\/article\/download\/184713","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T16:39:28Z","timestamp":1628613568000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.eurekaselect.com\/184713\/article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,3]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,8,3]]}},"alternative-id":["LiveAll1"],"URL":"https:\/\/doi.org\/10.2174\/1574884715666200810095225","relation":{},"ISSN":["2772-4328"],"issn-type":[{"value":"2772-4328","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8,3]]},"assertion":[{"value":"Peer Reviewed","order":0,"name":"review_status","label":"Review Status","group":{"name":"peer_review_details","label":"Peer Review Details"}},{"value":"Single blind","order":1,"name":"review_process","label":"Review Process","group":{"name":"peer_review_details","label":"Peer Review Details"}},{"value":"Checked with iThenticate","order":0,"name":"screening_status","label":"Screening Status","group":{"name":"plagiarism_screening","label":"Plagiarism Screening"}},{"value":"2020-03-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-23","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}