Refering to the March 2005 ISPD guidelines Table 6, for continuous dose of antibiotics for eg. amikacin, LD 25, MD 12; Am I right to say that if my patient is on 60 cycles of PD then i will have to give a LD 25mg/l in the first bag and then subsequently MD 12mg/L. Do i have a ceiling dose for the antibiotic? If i have interpreted the table wrongly, how should i ulitise the information provided in table 6?
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Questions About PD
Refering to the March 2005 ISPD guidelines Table 6, for continuous dose of antibiotics for eg. amikacin, LD 25, MD 12; Am I right to say that if my patient is on 60 cycles of PD then i will have to give a LD 25mg/l in the first bag and then subsequently MD 12mg/L. Do i have a ceiling dose for the antibiotic? If i have interpreted the table wrongly, how should i ulitise the information provided in table 6?
1 answer
yes, you are right. But why is your patient on 60 cycles of PD? The dosing is based on pharmacokinetic studies on CAPD rather than very rapid cycles. There is an adjustment of 25% increase in dosing if patients have significant RRF. If you increases the dosing, your patient may be at risk of drug toxicity. If a drug has a very high safety therapeutic margin, you may cautiously try increasing the dosage if you think your patient need higher dosage for effect, but obviously, you need to monitor the side effect more closely. checking drug level if available is recommended.
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