Comparison of Estimated Glomerular Filtration Rate Equations for Dosing Antibiotics in Chronic Kidney Disease Patients Dewi Latifatul Ilma1*, Fita Rahmawati2, Djoko Wahyono3
1Lecturer, Department of Pharmacy, Jenderal Soedirman University, Indonesia
2Associate Professor, Faculty of Pharmacy, Universitas Gadjah Mada, Indonesia
3Professor, Faculty of Pharmacy, Universitas Gadjah Mada, Indonesia
Email: dewilatifatulilma[at]unsoed.ac.id (corresponding author)
Abstract
Background: Antibiotics dose require dose adjustment according to renal function in chronic kidney disease patients. The optimal glomerular filtration rate (GFR) estimation equations remain uncertain to assess the individual patient s GFR as the degree of dose adjustment.
Purpose: To determine the dose adjustment of antibiotics in patients with chronic kidney disease based on the estimation of glomerular filtration rate (eGFR) using the Cockroft Gault (CG), the Modification of Diet in Renal Disease formula (MDRD), and the Chronic Kidney Disease Epidemiology Collaborative (CKD EPI) equations.
Methods: A cross-sectional study was conducted in chronic kidney disease patients who had used antibiotics when admitted to the hospitals during January-December 2017. The data were collected from the patients medical records in two hospitals in Yogyakarta and analyzed using the Kruskal Wallis test. In this study, 131 medical records were assessed.
Results: The study found that no significant differences (Chi square=1.5968, df=2, p=0.45) among the calculation of eGFR using CG, MDRD, and CKD EPI equations. Antibiotics dose were unadjusted properly in 38.29% antibiotic using the CG equation, 38.51% antibiotic using the MDRD equation, and 38.07% antibiotic using the CKD EPI equation. The most frequently used antibiotic that needs dose adjustment was ceftazidime (16.53%).
Conclusion: Although the three equations showed no significant differences to calculate eGFR using CG, MDRD, and CKD EPI, there is a slight difference in the percentage of unadjusted antibiotics dose.
