A Survey of Pharmacists in Academia on the Current Practice of Estimation of Kidney Function for Antimicrobial Dosing in Adults.

PURPOSE: To determine the methods used by pharmacists in academia to estimate kidney function for antimicrobial dosing.

METHODS: Stratified by region, a random sample of Accreditation Council for Pharmacy Education recognized Colleges of Pharmacy was selected for a total of 40 programs. Identified college Web sites were reviewed for eligible participants using the predefined inclusion/exclusion criteria. This was used to create a sampling frame from which 30% and 20% of faculty were randomly chosen and invited to participate via e-mail and mail-administered surveys, respectively.

RESULTS: Of the responders, 86% (31 of 36) who routinely estimate kidney function utilized the Cockcroft-Gault (CG) equation. In obese patients, 75% utilized the CG equation with or without adjustments. In patients ≥65 years, 42% adjusted serum creatinine to 1 mg/dL and 25% did not make any modifications. The majority of the responders accounted for patients with quadripalegia or bed-bound patients when estimating kidney function. In scenario examples, 51% (18 of 35) dosed an elderly female and 51% (18 of 35) a morbidly obese female as creatinine clearance ≥50 mL/min; however, 49% (17 of 35) did not.

CONCLUSION: The majority of responders utilized the CG equation for estimating kidney function with or without adjustments. Although a number of consistencies were noted, discrepancies existed, especially with elderly and obese patients.