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Vol. 15. Núm. 1.
Páginas 49-63 (Marzo 2011)
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Vol. 15. Núm. 1.
Páginas 49-63 (Marzo 2011)
DOI: 10.1016/S0123-9392(11)70076-5
Open Access
Consenso de uso de antimicrobianos en pacientes críticamente enfermos con falla renal o en riesgo de padecerla
Consensus for antimicrobial use in critically ill patients with renal failure or at risk of suffering it
Visitas
1309
Jorge Alberto Cortés1,
Autor para correspondencia
jorgecortes@yahoo.com

Oficina 510, Departamento de Medicina Interna, Edificio Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia. Teléfono: (571) 316-5000, extensión 15011.
, Rodolfo Soto2, Carlos Arturo Álvarez3, Giancarlo Buitrago1, Rubén Darío Camargo4, Juan Carlos Cataño5, Carlos Hernando Gómez3, Erwin Otero6, Patricia Reyes7, Gustavo Roncancio8, Juan Guillermo Vargas9
1 Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
2 Centro Médico Imbanaco, Cali, Colombia
3 Hospital Universitario San Ignacio, Bogotá, D.C., Colombia
4 Clínica General del Norte, Barranquilla, Colombia
5 Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
6 Programa de Terapias Extracorpóreas en UCI, Fresenius Medical Care, Bogotá, D.C., Colombia
7 Clínica Universitaria Colombia, Bogotá, D.C., Colombia
8 Pontificia Universidad Bolivariana, Medellín, Colombia
9 Hospital Universitario Mayor Méderi, Bogotá, D.C., Colombia
Este artículo ha recibido
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Visitas

Under a Creative Commons license
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Un número creciente de pacientes críticamente enfermos son atendidos por sepsis secundaria a infecciones bacterianas o micóticas. En este grupo de pacientes la sepsis per se es un factor de riesgo para el desarrollo de falla renal, la cual implica un mayor riesgo de mortalidad. Un panel de expertos en las áreas de infectología, cuidado crítico y nefrología prepararon un consenso basado en la información actual (“evidencia”) sobre el uso de antimicrobianos (antibióticos y antifúngicos) en pacientes críticamente enfermos con falla renal o en riesgo de padecerla. Se identificó la literatura científica relevante mediante un proceso de búsqueda sistemática y se generaron recomendaciones por medio del método presencial Delphi. Se propone que las recomendaciones de este consenso sean utilizadas por los trabajadores de la salud que manejen este grupo de pacientes, con el fin de identificar aquellos en mayor riesgo de progresión a falla renal y establecer las estrategias terapéuticas que tengan el mayor beneficio con la menor probabildad de efectos secundarios serios sobre la función renal. Se adicionó una estrategia para la implmentación de estas recomendaciones.

Palabras clave:
Agentes antibacterianos
agentes antifúngicos
insuficiencia renal
lesión renal aguda
consenso
toxicidad de drogas
Abstract

A growing number of critically ill patients are being taken care with sepsis secondary to bacterial or mycotic infections. In this group of patients, sepsis per se is a risk factor for the development of renal failure, which has been related to an increased risk of hospital mortality. An expert panel in infectious diseases, critical care and renal diseases prepared an evidence based consensus over the use of antimicrobials (antibacterial and antifungal agents) in critically ill patients with renal failure or at risk of suffering it. A sytematic review of the scientific literature was performed and recommendations were established by means of a consensus using the Delphi method. Recommendations proposed by this consensus are intended to be use by healthcare workers who are in charge of this kind of patients with the aim to identify the group of patients with higher risk of developing renal failure and to establish the therapeutic measures theat have the best outcome and lower frequency of severe side effects in renal function. An implementation strategy was added with the recommendations.

Key words:
Antibacterial agents
antifungal agents
acute renal failure
acute renal injury
consensus
drug toxicity
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Copyright © 2011. Asociación Colombiana de Infectología (ACIN)
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