Aminoglycosides in Critically Ill Septic Patients With Acute Kidney Injury Receiving Intermittent Hemodialysis: A Multicenter, Observational Study

Purpose Data on aminoglycoside stewardship in critically ill septic patients with acute kidney injury (AKI) needing intermittent hemodialysis (IH) are scarce. The first objective of the study was to evaluate whether administration occurs before vs after IH real-life management AKI IH. second assess delay achieving a potential reinjection window for dose aminoglycoside, which should be obtained postdialysis predialysis regimen. Methods A post hoc observational analysis multicenter randomized trial renal replacement therapy conducted. Inclusion criteria consisted any receiving during an antimicrobial episode. Findings Among 206 341 (60%) aminoglycosides, 90 underwent (46 previous continuous and 44 without). Amikacin gentamicin were administered mean (SD) 2.2 (1.5) 2.5 (2.1) days doses 20.6 (6.6) 5.4 (2.5) mg/kg, respectively. In undergoing exclusive IH, aminoglycosides 53% episodes versus 35% schedule. Cmin target earlier schedule (33.9 [14.2] hours 50.9 [12.2] hours, P = 0.009). Implications Despite being less frequently used than schedule, remains regular practice intensive care unit. reduces interval time tolerable redosing.