Document resource
Background and Importance Appropriate dosage adjustment of new beta-lactam antibiotics in patients with renal impairment is crucial to ensure both therapeutic effectiveness and safety. As these agents represent a significant advancement in the treatment of severe infections, precise dosing becomes especially important in these patients.Aim and Objectives To review prescriptions of patients with renal impairment receiving new beta-lactam antibiotics in order to determine whether appropriate dosage adjustments are applied.Material and Methods An observational, descriptive, retrospective study was conducted from the introduction of new β-lactam antibiotics at the hospital until September 2025. Patients with a glomerular filtration rate (GFR) <50 mL/min/1.73 m 2 were selected from the overall treated population. Data collected: sex, age, GFR, actual prescribed dose and reason for treatment discontinuation. Dose adjustments were evaluated based on the 2025 Antimicrobial Therapeutic Guidelines. Antibiotics studied: aztreonam/avibactam, cefiderocol, ceftaroline, ceftazidime/avibactam, ceftobiprole, ceftolozane/tazobactam and meropenem/vaborbactam. Data were obtained from electronic medical records (DIRAYA) and electronic prescription program (PRISMA).Results 100 patients were analysed; 33 had a GFR <50 mL/min/1.73 m 2 (66.6% male; mean age 70.8 ± 11.4 years). 41 treatment lines with new β-lactam antibiotics were recorded among these patients according to GFR variations during hospitalisation. Dose adjustments were observed in 28.6% of prescriptions for patients with a GFR of 30–50 mL/min; 28.6% for those with a GFR of 10–30 mL/min, and 40% for patients with a GFR <10 mL/min. The proportion of appropriately adjusted prescriptions of each antibiotic was as follows: ceftobiprole 60.0%, ceftaroline 50.0%, ceftazidime/avibactam 25.0%, cefiderocol 16.7%, and ceftolozane/tazobactam 0%. Reasons for treatment discontinuation were: exitus (48.5%, n=16), clinical improvement (30.3%, n=10), switch to targeted therapy (9.1%, n=3), clinical deterioration (6.1%, n=2) and antibiotic adverse effect (3.0%, n=1). One patient remains on treatment.Conclusion and Relevance The results demonstrate a persistent underutilisation of recommended renal dose adjustments for new beta-lactam antibiotics in everyday clinical practice, highlighting a clear opportunity to optimise patient management.These findings may suggest that active involvement of pharmacists, as part of a multidisciplinary team, could play a key role in improving the review and adjustment of dosing regimens.Conflict of Interest No conflict of interest