Auic Auc024 hMIC

The AUIC is predictive of bacterial eradication in vivo and has resulted in the recommendation that pseudomonal pneumonia be treated with a dose of 400 mg of ciprofloxacin every 8 h and not 200 mg every 12 h (ForresLef..a/ 1993).

Vancomycin, teicoplanin, the aminoglycosides, the cephalosporins, and the penicillins are all excreted by the kidneys and will accumulate when creatinine clearance falls below 30 ml/min. Erythromycin, clindamycin, chloramphenicol, fusidic acid, and rifampin (rifampicin) are metabolized in the liver and, although safe in renal failure, should be avoided in liver failure.

Clearance by hemodialysis or hemofiltration depends on the type of machine, the flow rates, and the duration ( Table...!) (C..o.t.t.e.dl.l 1.9.9.5). Aminoglycoside dosage must be determined by serum assay. The cephalosporins are eliminated slowly but dosage is usually reduced by at least half. The glycopeptides need only be given every 3 to 7 days after loading.

table 1 Dosage of parenteral antibiotics in critically ill patients and those with renal or hepatic failure

Antibiotic

Dosage

Renal failure

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