薬理と治療

Abstract

Background　The parameters used for evaluating the renal function of patients are the measured glomerular filtration rate（GFR）, estimated glomerular filtration rate （eGFR）, and estimated creatinine clearance（CCr）. However, little is known about which of these parameters physicians use to evaluate renal function and how they determine prescription doses in an actual clinical setting. Methods　CCr levels were calculated for 249 patients who had been prescribed levofloxacin at our hospital. Based on these CCr levels, the patients were divided into proper administration group and deviant administration groups. Moreover, eGFR levels and unadjusted eGFR levels were also calculated, and these renal function values were then compared between the two groups to examine whether any differences arose compared with the CCr-based evaluation. Results　In the end, 189 patients （75.9％）were categorized into the proper administration group and 60（24.1％）into the deviant administration group. Meanwhile, the proper administration rates, as evaluated based on the eGFR and unadjusted eGFR levels, were 83.1％ and 77.9％, respectively. Overall, the evaluation results based on the eGFR and unadjusted eGFR levels were inconsistent with the CCr-based evaluation results for 34 （13.6％）and 25（10.0％） patients, respectively. Conclusion　The results of this study indicate that physicians are highly likely to determine doses for prescriptions based on the eGFR levels displayed on electronic medical charts, thereby indicating that the evaluation of patientsʼ renal functions may not be accurate.