Augmented renal clearance (ARC) refers to the state of heightened renal filtration commonly\nobserved in the critically ill. Its prevalence in this patient population is a consequence of the bodyâ??s\nnatural response to serious disease, as well as the administration of fluids and pharmacologic therapies\nnecessary to maintain sufficient blood pressure. ARC is objectively defined as a creatinine clearance\nof more than 130 mL/min/1.73 m2 and is thus a crucial condition to consider when administering\nantibiotics, many of which are cleared renally. Using conventional dosing regimens risks the possibility\nof subtherapeutic concentrations or clinical failure. Over the past decade, research has been conducted\nin patients with ARC who received a number of antibacterials frequently used in the critically ill,\nsuch as piperacillin-tazobactam or vancomycin. Strategies to contend with this condition have also\nbeen explored, though further investigations remain necessary.
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