Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408 |
Resumo: | Introduction: Determination of renal function is particularly important when prescribing antibiotics to elderly patients. This study aims to determine the correlation between estimated creatinine clearance and the estimated glomerular filtration rate, for a hospitalized population of very elderly patients, and to audit antibiotic prescribing errors.Material and Methods: Retrospective cohort study of all patients ≥ 80 years hospitalized with antibiotic. Creatinine clearance was calculated using Cockcroft-Gault equation and estimated glomerular filtration rate by Modification of Diet in Renal Disease Study and Chronic Kidney Disease Epidemiology Collaboration equations. Dosing errors were determined through adjustment of daily define dose to renal function.Results: The study included 589 patients. The correlation of Cockcroft-Gault with Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration was r = 0.98 and 0.96 for the minimum serum creatinine, and 0.97 and 0.93 for the maximum serum creatinine. Based on Cockcroft-Gault, there were errors in the daily defined dose in 45% in the minimum serum creatinine, and 52% in the maximum serum creatinine day. There was a discrepancy in the recording of errors of 14% to 16% when Cockcroft-Gault was compared with Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration.Discussion: There was a good correlation of Cockcroft-Gault with the estimated glomerular filtration rate by Modification of Diet in Renal Disease or Chronic Kidney Disease Epidemiology Collaboration. Regardless of the equation used to estimate renal function there was a high rate of antibiotic dosing errors documented in this population.Conclusion: This study supports the maintenance of the Cockcroft-Gault equation for drug dosing in the very elderly population. Further studies are needed to investigate underlying causes of prescribing errors. |
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Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort StudyCorrelação entre a Clearance da Creatinina Estimada e a Taxa de Filtração Glomerular Estimada nos Doentes Muito Idosos e Erros de Prescrição dos Antibióticos: Um Estudo de CoorteAged80 and overAgingAnti-Bacterial AgentsCreatinineGlomerular Filtration RateMedication ErrorsAntibacterianosCreatininaEnvelhecimentoErros de MedicaçãoIdoso de 80 Anos ou maisTaxa de Filtração GlomerularIntroduction: Determination of renal function is particularly important when prescribing antibiotics to elderly patients. This study aims to determine the correlation between estimated creatinine clearance and the estimated glomerular filtration rate, for a hospitalized population of very elderly patients, and to audit antibiotic prescribing errors.Material and Methods: Retrospective cohort study of all patients ≥ 80 years hospitalized with antibiotic. Creatinine clearance was calculated using Cockcroft-Gault equation and estimated glomerular filtration rate by Modification of Diet in Renal Disease Study and Chronic Kidney Disease Epidemiology Collaboration equations. Dosing errors were determined through adjustment of daily define dose to renal function.Results: The study included 589 patients. The correlation of Cockcroft-Gault with Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration was r = 0.98 and 0.96 for the minimum serum creatinine, and 0.97 and 0.93 for the maximum serum creatinine. Based on Cockcroft-Gault, there were errors in the daily defined dose in 45% in the minimum serum creatinine, and 52% in the maximum serum creatinine day. There was a discrepancy in the recording of errors of 14% to 16% when Cockcroft-Gault was compared with Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration.Discussion: There was a good correlation of Cockcroft-Gault with the estimated glomerular filtration rate by Modification of Diet in Renal Disease or Chronic Kidney Disease Epidemiology Collaboration. Regardless of the equation used to estimate renal function there was a high rate of antibiotic dosing errors documented in this population.Conclusion: This study supports the maintenance of the Cockcroft-Gault equation for drug dosing in the very elderly population. Further studies are needed to investigate underlying causes of prescribing errors.Introdução: A determinação da função renal é particularmente importante na prescrição de antibióticos em doentes idosos. O objetivo deste estudo é correlacionar a clearance de creatinina com a taxa de filtração glomerular estimada, numa população hospitalizada de doentes muito idosos, e auditar os erros de prescrição antibiótica.Material e Métodos: Coorte retrospetivo de todos os doentes ≥ 80 anos hospitalizados com antibioterapia prescrita. A clearance de creatinina foi calculada através da equação Cockcroft-Gault, e a filtração glomerular estimada através das equações Modification of Diet in Renal Disease e Chronic Kidney Disease Epidemiology Collaboration. Os erros de prescrição foram determinados pelo ajuste da dose diária definida à função renal.Resultados: Foram incluídos 589 doentes. A correlação da Cockcroft-Gault com Modification of Diet in Renal Disease e Chronic Kidney Disease Epidemiology Collaboration foi r = 0,98 e 0,96 para a creatinina sérica mínima, e 0,97 e 0,93 para a creatinina sérica máxima. Com base na Cockcroft-Gault, a taxa de erro na dose diária definida foi 45% no dia da creatinina sérica mínima e 52% no dia da creatinina sérica máxima. Quando a Cockcroft-Gault foi comparada com a Modification of Diet in Renal Disease e a Chronic Kidney Disease Epidemiology Collaboration houve uma discrepância no registo de erros de 14% a 16%, respetivamente.Discussão: Verificou-se uma boa correlação entre a Cockcroft-Gault e as equações que calculam a filtração glomerular: Modification of Diet in Renal Disease ou Chronic Kidney Disease Epidemiology Collaboration. Independentemente da equação utilizada para estimar a função renal, foi documentada uma taxa elevada de erros na dose de antibióticos prescrita nesta população.Conclusão: Este estudo reforça a manutenção do uso da equação de Cockcroft-Gault para calcular a dose adequada de antibióticos na população muito idosa. Mais estudos são necessários para investigar as causas subjacentes aos erros de prescrição.Ordem dos Médicos2021-05-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/pngapplication/postscriptapplication/postscriptapplication/pdfimage/jpegimage/jpegimage/pnghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408oai:ojs.www.actamedicaportuguesa.com:article/12408Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 335-341Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 335-3411646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/6033https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11461https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11462https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11463https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11550https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11552https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11553https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/12156Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSilva, Manuel AlbertoDias, GustavoCardoso, Teresa2022-12-20T11:06:36Zoai:ojs.www.actamedicaportuguesa.com:article/12408Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:11.066280Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study Correlação entre a Clearance da Creatinina Estimada e a Taxa de Filtração Glomerular Estimada nos Doentes Muito Idosos e Erros de Prescrição dos Antibióticos: Um Estudo de Coorte |
title |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study |
spellingShingle |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study Silva, Manuel Alberto Aged 80 and over Aging Anti-Bacterial Agents Creatinine Glomerular Filtration Rate Medication Errors Antibacterianos Creatinina Envelhecimento Erros de Medicação Idoso de 80 Anos ou mais Taxa de Filtração Glomerular |
title_short |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study |
title_full |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study |
title_fullStr |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study |
title_full_unstemmed |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study |
title_sort |
Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study |
author |
Silva, Manuel Alberto |
author_facet |
Silva, Manuel Alberto Dias, Gustavo Cardoso, Teresa |
author_role |
author |
author2 |
Dias, Gustavo Cardoso, Teresa |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Silva, Manuel Alberto Dias, Gustavo Cardoso, Teresa |
dc.subject.por.fl_str_mv |
Aged 80 and over Aging Anti-Bacterial Agents Creatinine Glomerular Filtration Rate Medication Errors Antibacterianos Creatinina Envelhecimento Erros de Medicação Idoso de 80 Anos ou mais Taxa de Filtração Glomerular |
topic |
Aged 80 and over Aging Anti-Bacterial Agents Creatinine Glomerular Filtration Rate Medication Errors Antibacterianos Creatinina Envelhecimento Erros de Medicação Idoso de 80 Anos ou mais Taxa de Filtração Glomerular |
description |
Introduction: Determination of renal function is particularly important when prescribing antibiotics to elderly patients. This study aims to determine the correlation between estimated creatinine clearance and the estimated glomerular filtration rate, for a hospitalized population of very elderly patients, and to audit antibiotic prescribing errors.Material and Methods: Retrospective cohort study of all patients ≥ 80 years hospitalized with antibiotic. Creatinine clearance was calculated using Cockcroft-Gault equation and estimated glomerular filtration rate by Modification of Diet in Renal Disease Study and Chronic Kidney Disease Epidemiology Collaboration equations. Dosing errors were determined through adjustment of daily define dose to renal function.Results: The study included 589 patients. The correlation of Cockcroft-Gault with Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration was r = 0.98 and 0.96 for the minimum serum creatinine, and 0.97 and 0.93 for the maximum serum creatinine. Based on Cockcroft-Gault, there were errors in the daily defined dose in 45% in the minimum serum creatinine, and 52% in the maximum serum creatinine day. There was a discrepancy in the recording of errors of 14% to 16% when Cockcroft-Gault was compared with Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration.Discussion: There was a good correlation of Cockcroft-Gault with the estimated glomerular filtration rate by Modification of Diet in Renal Disease or Chronic Kidney Disease Epidemiology Collaboration. Regardless of the equation used to estimate renal function there was a high rate of antibiotic dosing errors documented in this population.Conclusion: This study supports the maintenance of the Cockcroft-Gault equation for drug dosing in the very elderly population. Further studies are needed to investigate underlying causes of prescribing errors. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05-02 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408 oai:ojs.www.actamedicaportuguesa.com:article/12408 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/12408 |
dc.language.iso.fl_str_mv |
eng |
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eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/6033 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11461 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11462 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11463 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11550 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11552 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/11553 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408/12156 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2020 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa |
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openAccess |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 335-341 Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 335-341 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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