Evidence map›Paper›PMID 30630861›Full record

ArticleClinical journal of the American Society of Nephrology : CJASN2019

Clinical Outcomes of Failing to Dose-Reduce Cephalosporin Antibiotics in Older Adults with CKD.

Lavanya Bathini, Racquel Jandoc, Paul Kuwornu, Eric McArthur, Matthew A Weir, Manish M Sood, Marisa Battistella, Flory T Muanda, Aiden Liu, Arsh K Jain and 1 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical journal of the American Society of Nephrology : CJASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Lavanya BathiniInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Racquel JandocInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Paul KuwornuInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Eric McArthurInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Matthew A WeirInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Manish M SoodInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Marisa BattistellaFaculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Flory T MuandaInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Aiden LiuInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Arsh K JainInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Amit X GargInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Institute for Clinical Evaluative Sciences · CAUniversity of Toronto · CAWestern University · CA

Funding

CIHR
6 · The paper itself

Abstract

BACKGROUND AND

objectivesCurrent dosing recommendations for cephalosporin antibiotics are on the basis of pharmacokinetic studies and are frequently ignored in practice. This study was undertaken to investigate the clinical outcomes of failing to dose-reduce cephalosporin antibiotics in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective cohort study conducted in Ontario, Canada using linked population-based health care databases. Nine thousand three hundred forty-seven outpatients (median age 83; interquartile range, 77-88 years; 57% women) with an eGFR<30 ml/min per 1.73 m

resultsPatients who received a higher than recommended dose of a cephalosporin antibiotic were similar in multiple indicators of baseline health to patients who received a reduced dose. Overall, 6% of patients presented to hospital with a possible cephalosporin side-effect, 13% failed antibiotic treatment, and 3% died. Compared with a reduced dose, receiving a higher dose of antibiotic was not associated with a different rate of side-effects (adjusted odds ratio, 1.00; 95% confidence interval, 0.84 to 1.20), treatment failure (1.01; 0.88 to 1.15), or death (0.99; 0.76 to 1.29).

conclusionsIn this study we failed to demonstrate any association between the dose of cephalosporin antibiotic administered to elderly patients with CKD and the risk of side-effects leading to hospitalization, treatment failure, or mortality.

Indexed as

Renal Insufficiency, ChronicAgedAged, 80 and overAnti-Bacterial AgentsCefprozilCefuroximeCephalexinCephalosporinsDatabases, FactualEmergency Service, HospitalFemaleGlomerular Filtration RateHospitalizationHumansMaleMortalityAnti-Bacterial AgentsCefprozilCefuroximeCephalexinCephalosporinsAgedAged, 80 and overAnti-Bacterial AgentscefprozilCefuroximeCephalexinCephalosporinsConfidence IntervalsEmergency Serviceglomerular filtration rateHospitalhospitalizationOdds RatioOutpatientsrenal dialysisRenal Insufficiency, ChronicRetrospective StudiesRiskTreatment Failure

Identifiers

PMID30630861
PMCPMC6390923
OpenAlexW2908646946

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.