South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Observational Study
Evaluating the usefulness of the estimated glomerular filtration rate for determination of imipenem dosage in critically ill patients.
Antibiotic dosing in critically ill patients is complicated by variations in the pharmacokinetics of antibiotics in this group. The dosing of imipenem/cilastatin is usually determined by severity of illness and renal function. ⋯ Considering the high mortality rate of sepsis in ICUs and the rapid global increase in antimicrobial resistance, it is crucial to dose antibiotics appropriately. Owing to the variability of antibiotic pharmacokinetics in critically ill patients, this task becomes almost impossible when relying on conventional dosing guidelines. This study found that eGFRs do not correlate with imipenem blood levels in critically ill patients and should not be used to determine the dose of imipenem/cilastatin. Instead, the dose should be individualised for patients through routine therapeutic drug monitoring.
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Editorial
The introduction of competency-based medical education for postgraduate training in South Africa.
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