ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2025, Vol. 34 ›› Issue (4): 381-385.DOI: 10.3969/j.issn.1006-298X.2025.04.016

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Dose adjustment of novel β-lactam antibiotic/β-lactamase inhibitor combination in continuous renal replacement therapy

  

  • Online:2025-08-28 Published:2025-08-28

Abstract: With the widespread use of antibiotics, bacterial resistance has emerged as a significant threat to human health. The combination of novel B-lactam antibiotics and β lactamase inhibitors represents an important strategy for treating multidrug⁃resistant bacterial infections in clinical settings. Patients with severe infections and acute kidney injury often depend on continuous renal replacement therapy (CRRT) to provide extracorporeal renal support. Four recently introduced antibiotics-ceftazidime⁃avibactam, ceftolozane⁃tazobactam, imipenem⁃cilastatin⁃relebactam, and meropenem⁃vaborbactam-are readily cleared during CRRT due to their low molecular weight, limited volume of distribution, low protein binding, and predominantly renal clearance. During CRRT, the pharmacokinetics and pharmacodynamics of these drugs may be altered, and inappropriate dosing regimens could result in treatment failure or the emergence of pathogen resistance. This article reviews and synthesizes the available pharmacokinetic data for these novel antibiotics in CRRT patients, aiming to inform the optimization of clinical dosing strategies.

Key words: font-family:Inter, -apple-system, BlinkMacSystemFont, ", font-size:16px, background-color:#F9FAFB, ">acute kidney injury, continuous renal replacement therapy, antibiotics, pharmacokinetic, drug dosage adjustment