METHODS
A prospective observational study was carried out in the department of the nephrology, Kasturba Hospital (KH). Data were collected for seven months (September 2016 to April 2017) after the approval of the Institutional Ethics Committee, Kasturba Hospital, Manipal (IEC no – 537/201). Patients (admitted with AKI and CKD, prescribed with antibiotics, were included in the study. Vulnerable patients, such as pregnant, pediatric, and psychiatric patients were excluded. A predesigned form was used to obtain demographic, biochemical, prescription, and clinical outcomes data. Prior Informed consent was obtained. The baseline infectious parameters were measured at the beginning of antibiotic therapy. . CrCl was estimated using the Cockroft-Gault method14 (conventional method) and the Jelliffe method15. The Cockroft-gault equation was used for patients with CKD and AKI, whereas the Jelliffe equation was used in patients with only AKI. Appropriateness of the dose was assessed by referring to standard databases like Micromedex, FDA labels, and product information leaflets published by respective manufacturers. Based on specified outcome measures such as an increase or decrease in WBC, ESR, body temperature, sterile culture, outcomes were termed as significant, followed by which impact of dose appropriateness on clinical outcome was assessed.
Statistical Analysis : Demographic data was expressed in frequency and percentage (%) followed by mean ± SD for continuous outcomes. Pearson’s Chi-square test was done to identify the association of dose appropriateness and clinical outcome. The statistical analysis was carried out in SPSS version 20.0 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Released 2012). A p-value of less than 0.05 was considered significant.