Key words:
Beta-Lactams, Critically, Hypernatremia, Sepsis.
Objectives: Antibiotic associated hypernatremia (AAH) is a frequent concern in critically ill patients who are taking β-lactam antibiotics (ABs) especially Piperacillin/Tazobactam. The consequences of AAH may have detrimental effects on critically ill patients. The objective of this study is to evaluate the AAH risk of the most commonly used broad spectrum β-lactam ABs.
Methods: We performed a retrospective analysis of patients admitted to the adult intensive care unit (ICU) between April 2017 and Sep 2018 who were their demographics, fluid inputs and outputs, antibiotics dose and duration, and corrected sodium can be obtained. Collected data were analyzed by one-way ANOVA test followed by Tukey Kramer Post Hoc test to determine the mean differences of significant dependent variables between the Meropenem (Group I), Imipenem/Cilastatin (Group II), Piperacillin/Tazobactam (Group III), and Cefepime (Group IV). Also, gender and risk of AAH were analyzed by chi square test.
Results: The mean overall age was 58.37±0.78 years, and 112 subjects (68.71%) were male. The overall risk of AAH was 12.3%. Group III patients had the highest risk of AAH (36.4%) followed by Group I (7.9%), Group II (2.4%), and finally Group IV (0.00%). The mean difference of corrected average sodium levels (cNa+avg) was significantly highest between Group III and IV (3.30±0.21) followed by Group I and IV (1.82±0.22) and finally between Group I and II (1.42±0.21).
Conclusion: Our results demonstrate that empirical or targeted use of β-lactam ABs is an independent risk of AAH especially in case of high dose of Piperacillin/Tazobactam and Meropenem.
