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.