A systematic review of the effect of renal replacement therapy on the pharmacokinetics of co-amoxiclav

Background & aim: Co-amoxiclav is a commonly used antibiotic, the dose administered during renal replacement therapy may be subtherapeutic. This study aims to describe the current literature on the pharmacokinetics and pharmacodynamics of co-amoxiclav in patients undergoing renal replacement therapy. Method: We carried out a systematic review of the available literature in MEDLINE, Embase, Pubmed, and Google Scholar from inception to Oct 2023. Studies were included if they reported pharmacokinetic data on adults given amoxicillin or clavulanic acid during renal replacement therapy. Results: Seven studies were identified which were published between 1984 to 2021. Variability was observed in the characteristics of the studies, the renal replacement therapy settings, the drug exposure, drug assay methods, and the analysis of the pharmacokinetic parameters. Conclusion: Further pharmacokinetic-pharmacodynamic studies are needed on co-amoxiclav during renal replacement therapy.