vedomostiregmedРегуляторные исследования и экспертиза лекарственных средствRegulatory Research and Medicine Evaluation3034-30623034-3453Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)10.30895/1991-2919-2021-11-4-239-245vedomostiregmed-377Research ArticleОБЗОРЫREVIEWSОсобенности дозирования антибиотиков при хронической болезни почекAntibiotic Dosing in Chronic Kidney Diseasehttps://orcid.org/0000-0003-0936-5551БунятянН. Д.BunyatyanN. D.

Бунятян Наталья Дмитриевна, доктор фармацевтических наук, профессор

Петровский б-р, д. 8, стр. 2, Москва, 127051

Natalia D. Bunyatyan, Dr. Sci. (Pharm), Professor 

8/2 Petrovsky Blvd, Moscow 127051

bunyatyan@expmed.ruhttps://orcid.org/0000-0002-0258-4092ПетровВ. И.PetrovV. I.

Петров Владимир Иванович, академик РАН, доктор медицинских наук, профессор

пл. Павших Борцов, д. 1, Волгоград, 400131

Vladimir I. Petrov, Academician of RAS, Dr. Sci. (Med.), Professor 

1 Pavshikh Bortsov Sq., Volgograd 400131

vipetrov@volgmed.ruhttps://orcid.org/0000-0002-7311-4549ШаталоваО. В.ShatalovaO. V.

Шаталова Ольга Викторовна, доктор медицинских наук, профессор

пл. Павших Борцов, д. 1, Волгоград, 400131

Olga V. Shatalova, Dr. Sci. (Med.), Professor 

1 Pavshikh Bortsov Sq., Volgograd 400131

shov_med@mail.ruhttps://orcid.org/0000-0002-8237-8335ПономареваА. В.PonomarevaA. V.

Пономарева Анжелика Викторовна, доктор медицинских наук, профессор

пл. Павших Борцов, д. 1, Волгоград, 400131

Anzhelika V. Ponomareva, Dr. Sci. (Med.), Professor 

1 Pavshikh Bortsov Sq., Volgograd 400131

shov_med@mail.ruhttps://orcid.org/0000-0002-4778-5015РязановаА. Ю.RyazanovaA. Yu.

Рязанова Анастасия Юрьевна, кандидат медицинских наук, доцент

пл. Павших Борцов, д. 1, Волгоград, 400131

Anastasia Yu. Ryazanova, Сand. Sci. (Med.), Associate Professor 

1 Pavshikh Bortsov Sq., Volgograd 400131

shov_med@mail.ruhttps://orcid.org/0000-0002-6565-2566ГорбатенкоВ. С.GorbatenkoV. S.

Горбатенко Владислав Сергеевич, кандидат медицинских наук, доцент

пл. Павших Борцов, д. 1, Волгоград, 400131

Vladislav S. Gorbatenko, Сand. Sci. (Med.), Associate Professor 

1 Pavshikh Bortsov Sq., Volgograd 400131

shov_med@mail.ruhttps://orcid.org/0000-0002-7957-3770ГерасименкоА. С.GerasimenkoA. S.

Герасименко Анастасия Сергеевна

пл. Павших Борцов, д. 1, Волгоград, 400131

Anastasia S. Gerasimenko 

1 Pavshikh Bortsov Sq., Volgograd 400131

shov_med@mail.ruhttps://orcid.org/0000-0002-6389-2099СоковаЕ. А.SokovaE. A.

Сокова Елена Андреевна, кандидат медицинских наук, доцент

Петровский б-р, д. 8, стр. 2, Москва, 127051

Elena A. Sokova, Сand. Sci. (Med.), Associate Professor 

8/2 Petrovsky Blvd, Moscow 127051

sokova@expmed.ruФедеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской ФедерацииРоссияScientific Centre for Expert Evaluation of Medicinal ProductsRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияVolgograd State Medical UniversityRussian Federation202115112021114239245Copyright © Бунятян Н.Д., Петров В.И., Шаталова О.В., Пономарева А.В., Рязанова А.Ю., Горбатенко В.С., Герасименко А.С., Сокова Е.А., 20212021Бунятян Н.Д., Петров В.И., Шаталова О.В., Пономарева А.В., Рязанова А.Ю., Горбатенко В.С., Герасименко А.С., Сокова Е.А.Bunyatyan N.D., Petrov V.I., Shatalova O.V., Ponomareva A.V., Ryazanova A.Y., Gorbatenko V.S., Gerasimenko A.S., Sokova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vedomostincesmp.ru/jour/article/view/377

Инфекционный процесс является важной причиной заболеваемости и смертности среди пациентов с хронической болезнью почек. При назначении антибактериальных препаратов необходимо учитывать фармакокинетические параметры препарата и индивидуальные особенности пациента. Обязательным условием достижения положительных результатов лечения при минимизации побочных эффектов является корректное дозирование антибиотиков. Цель работы – анализ данных литературы о факторах, влияющих на дозирование антибактериальных препаратов у пациентов с хронической болезнью почек. Поскольку большинство антибактериальных препаратов элиминируется почками, при снижении скорости клубочковой фильтрации или функции почек необходимо корректировать дозу, чтобы предотвратить кумуляцию препарата и уменьшить риск развития побочных эффектов. Дозирование антибактериальных препаратов у таких пациентов должно сопровождаться оценкой функции почек и быть сбалансировано с необходимостью обеспечения эффективного и безопасного лечения, а также предотвращения бактериальной резистентности. В обзоре приведены данные о дозировании конкретных групп антибиотиков (бета-лактамов, аминогликозидов, фторхинолонов) при различных показателях клиренса креатинина. При внепочечном пути выведения лекарственного препарата из организма коррекция дозы при хронической болезни почек, как правило, не требуется.

Infectious process is an important cause of morbidity and mortality among patients with chronic kidney disease. Prescription of antibacterial drugs should take into account the pharmacokinetic parameters of the medicine and the individual characteristics of the patient. Adequate antibiotic dosing is crucial for positive treatment outcome and minimisation of side effects. The aim of the study was to analyse scientific literature on factors affecting the dosing of antibacterials in patients with chronic kidney disease. Since most antibacterial medicines are eliminated by the kidneys, a decrease in glomerular filtration rate or kidney function should be followed by the dose adjustment in order to prevent the medicine accumulation and reduce the risk of side effects. Antibiotic dosing in such patients should be accompanied by kidney function assessment and be adjusted to ensure effective and safe treatment, as well as prevention of bacterial resistance. The review provides data on the dosing of some antibiotic groups (beta-lactams, aminoglycosides, fluoroquinolones) at different creatinine clearance rates. Extrarenal excretion of medicines does not usually require the dose adjustment in patients with chronic kidney disease.

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The authors declare that there are no conflicts of interest present.