A 45-year-old man on ICU with severe sepsis has augmented renal clearance (ARC) - his measured creatinine clearance is 180 mL/min (normal 90-120). He ...

Question

A 45-year-old man on ICU with severe sepsis has augmented renal clearance (ARC) - his measured creatinine clearance is 180 mL/min (normal 90-120). He is receiving standard-dose IV meropenem 1g TDS. Trough levels are subtherapeutic. What is ARC and how does it affect antibiotic dosing?

Accepted Answer

Augmented renal clearance is an increase in creatinine clearance above normal (>130 mL/min) seen in approximately 30-65% of critically ill patients; it accelerates the elimination of renally cleared drugs (including beta-lactams, vancomycin, aminoglycosides), causing subtherapeutic levels at standard doses - higher or more frequent dosing, or continuous infusions, may be needed

Answer

ARC is irrelevant to drug dosing

Answer

ARC only affects oral medications

Answer

ARC means the kidneys have failed

Answer

ARC reduces drug clearance

uk-fficm MCQ (SBA): Augmented Renal Clearance

A 45-year-old man on ICU with severe sepsis has augmented renal clearance (ARC) - his measured creatinine clearance is 180 mL/min (normal 90-120). He is receiving standard-dose IV meropenem 1g TDS. Trough levels are subtherapeutic. What is ARC and how does it affect antibiotic dosing?