Augmented renal clearance and therapeutic monitoring of β-lactams

Andrew A. Udy, Jan J. De Waele, Jeffrey Lipman

Research output: Contribution to journalEditorialOtherpeer-review

28 Citations (Scopus)


Successful application of antibacterial therapy in the critically ill requires an appreciation of the complex interaction between the host, the causative pathogen and the chosen pharmaceutical. A pathophysiological change in the intensive care unit (ICU) patient challenging the 'one dose fits all' concept includes augmented renal clearance (ARC), defined as a creatinine clearance (CLCr) of =130 mL/min. Ideally, CLCr values should be obtained by a timed measured collection of urine, with plasma and urine creatinine levels. Increased renal clearance of antibiotics also occurs in the ICU patient and therefore β-lactam antibiotic exposure in the critically ill could easily lead to trough drug concentrations below therapeutic ranges. One way to document and alter drug levels is via therapeutic drug monitoring (TDM). The interactions of ARC and β-lactam TDM are further explored in this article in specific reference to a concomitant article in this issue of the journal.

Original languageEnglish
Pages (from-to)331-333
Number of pages3
JournalInternational Journal of Antimicrobial Agents
Issue number4
Publication statusPublished - 2015
Externally publishedYes


  • Augmented renal clearance
  • Therapeutic drug monitoring
  • β-Lactam antibiotics

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