ABSTRACT
Antibiotic prescription in chronic kidney disease patients poses a twofold problem. The appropriate use of antibacterial agents is essential to ensure efficacy and to prevent the emergence of resistance, and dosages should be adapted to the renal function to prevent adverse effects. SiteGPR is a French website for health professionals to help with prescriptions to chronic kidney disease patients. A working group of infectious disease specialists and nephrology pharmacists reviewed the indications, dosing regimens, administration modalities, and dose adjustments of antibiotics marketed in France for patients with renal failure. Data available on the SiteGPR website and detailed in the present article aims to provide an evidence-based update of infectious disease recommendations to health professionals managing patients with chronic kidney disease.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Infectious Disease Medicine/methods , Renal Insufficiency, Chronic/metabolism , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/pharmacokinetics , Biotransformation , Dose-Response Relationship, Drug , Drug Monitoring , Evidence-Based Medicine , Humans , Immunocompromised Host , Kidney/drug effects , Kidney/metabolism , Practice Guidelines as Topic , Prescription DrugsABSTRACT
Since the 1970s, drugs unused by French households have been collected for humanitarian aid. In 1993, the Cyclamed system was created by pharmacists in order to manage and collect unused drugs. However, experience has shown that in developing countries unused drugs caused more problems than they solved, including: poorly adapted to the needs of the population, poor quality of the collected medicines, interferences with local pharmaceutical policies, misappropriation... As recommended by the World Health Organisation, most of the humanitarian organizations stopped unused drug donations. In France this practice has been forbidden since the 1st of January 2009. Associations that still desire to send unused drugs to developing countries must develop other approaches, such as essential generic medicines or emergency health kits.