RESULTS
We identified 163 patients of which 139 fulfilled the inclusion criteria. The reasons for dropouts were missing data or complicated medication regimen. The mean age of patients was 54.75±13.36. The study showed that the majority (112) of the patients were diagnosed with CKD. The sample consisted of significant male adults (108). The mean length of stay (LOS) for patients was noted to be 6±2.5 days. The detailed demographic details are presented in Table. 1.
Urinary tract infections (UTI) were seen in most of the patients, followed by systemic, bloodstream infections (BSI) and respiratory infections. Gastrointestinal infections were the least (Fig. 1). Most of the patients received monotherapy, followed by dual therapy during their hospitalization. In majority antibiotics were appropriately dosed (63.3%). Most had a favorable clinical outcome (Fig. 2).
Cefoperazone-sulbactam followed by ceftriaxone, vancomycin, meropenem, levofloxacin, ceftazidime were the common antibiotics administered (Fig. 3). Of 27 with AKI, only 20 were analyzed as they had data on required parametersIn patients with AKI having highly unstable serum creatinine, the Cockroft-Gault method overestimated the CrCl value with a mean difference of 4.55ml/min. The relationship between dose appropriateness and clinical outcome in AKI demonstrated that dosing adjustment was not a significant factor (p= 0.4) in achieving a favorable clinical outcome.
In CKD patients, a significant correlation between dose adjustment and clinical outcome (p=0.001) was obtained (Table. 2). The appropriateness of dosing in CKD patients receiving monotherapy, dual therapy, or triple therapy was compared, which identified that suitable dosing in dual therapy (p=0.001) had a significant effect on positive clinical outcomes (Table. 3).