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Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study

2021-05Journal article Open access
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dc.contributor.authorSilva, Manuel Alberto
dc.contributor.authorDias, Gustavo
dc.contributor.authorCardoso, Teresa
dc.date.accessioned2023-10-10T11:24:05Z
dc.date.available2023-10-10T11:24:05Z
dc.date.issued2021-05
dc.description.abstractIntroduction: 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.pt_PT
dc.description.abstractIntrodução: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSilva MA, Dias G, Cardoso T. Correlation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Study. Acta Med Port. 2021;34(5):335-341. doi:10.20344/amp.12408pt_PT
dc.identifier.doi10.20344/amp.12408pt_PT
dc.identifier.issn0870-399X
dc.identifier.issn1646-0758
dc.identifier.urihttp://hdl.handle.net/10400.16/2792
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCentro Editor Livreiro da Ordem dos Médicospt_PT
dc.relation.publisherversionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12408pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectAged, 80 and overpt_PT
dc.subject;Agingpt_PT
dc.subjectAnti-Bacterial Agentspt_PT
dc.subjectCreatininept_PT
dc.subjectGlomerular Filtration Ratept_PT
dc.subjectMedication Errorspt_PT
dc.titleCorrelation of Estimated Creatinine Clearance and Glomerular Filtration Rate in Very Elderly Patients and Antibiotic Prescribing Errors: Cohort Studypt_PT
dc.title.alternativeCorrelação 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 Coortept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlacePortugalpt_PT
oaire.citation.endPage341pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage335pt_PT
oaire.citation.titleActa Médica Portuguesapt_PT
oaire.citation.volume34pt_PT
person.familyNameCardoso
person.givenNameTeresa
person.identifier.ciencia-idED18-4D88-D80E
person.identifier.orcid0000-0003-2451-4260
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication0a16d535-7399-470a-bd45-0f229153e2e0
relation.isAuthorOfPublication.latestForDiscovery0a16d535-7399-470a-bd45-0f229153e2e0

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