
The study evaluates how antibiotics can be ineffective in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) due to highly variable pharmacokinetics parameters. This variability is caused by altered physiology in critical illness, which affects the clearance of drugs primarily cleared by the kidneys. Mathematical estimates of glomerular filtration rate, such as the Cockcroft-Gault formula, have not been validated for use with critically ill patients, especially those with augmented renal clearance (ARC). ARC is linked to inadequate antibiotic exposure and unsuccessful treatment, so it is crucial to measure creatinine clearance accurately and increase antibiotic dosage accordingly. Although mathematical estimates are unreliable in critically ill patients, they are still commonly used.
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