Kidney failure related to broad-spectrum antibiotics in critically ill patients: secondary end point results from a 1200 patient randomised trial

Jens-Ulrik Stæhr Jensen, Lars Hein, Bettina Lundgren, Morten Heiberg Bestle, Thomas Mohr, Mads Holmen Andersen, Klaus Julius Thornberg, Jesper Løken, Morten Steensen, Zoë Fox, Hamid Tousi, Peter Søe-Jensen, Anne Øberg Lauritsen, Ditte Gry Strange, Nanna Reiter, Katrin Thormar, Paul Christian Fjeldborg, Kim Michael Larsen, Niels-Erik Drenck, Maria Egede JohansenLene Ryom Nielsen, Jesper Kjær, Jesper Grarup, Jens D Lundgren, The Procalcitonin And Survival Study (PASS) Group, Christian Østergaard Andersen

71 Citationer (Scopus)

Abstract

OBJECTIVES: To explore whether a strategy of more intensive antibiotic therapy leads to emergence or prolongation of renal failure in intensive care patients. DESIGN: Secondary analysis from a randomised antibiotic strategy trial (the Procalcitonin And Survival Study). The randomised arms were conserved from the primary trial for the main analysis. SETTING: Nine mixed surgical/medical intensive care units across Denmark. PARTICIPANTS: 1200 adult intensive care patients, 18+ years, expected to stay +24 h. Exclusion criteria: bilirubin >40 mg/dl, triglycerides >1000 mg/dl, increased risk from blood sampling, pregnant/breast feeding and psychiatric patients. INTERVENTIONS: Patients were randomised to guideline-based therapy ('standard-exposure' arm) or to guideline-based therapy supplemented with antibiotic escalation whenever procalcitonin increased on daily measurements ('high-exposure' arm). MAIN OUTCOME MEASURES: Primary end point: estimated glomerular filtration rate (eGFR)
OriginalsprogEngelsk
TidsskriftBMJ Open
Vol/bind2
Udgave nummer2
Sider (fra-til)e000635
DOI
StatusUdgivet - 2012

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