How to Perform Pharmacokinetic Research of Antimicrobial Drugs in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy: A Scoping Review of all Relevant Pharmacokinetic Factors-An Executive Summary.

BACKGROUND: Critically ill patients in the intensive care unit represent a highly heterogeneous population with large variations in the pharmacokinetics (PK) of antimicrobials (antibiotics, antifungals, and antiviral agents), complicating optimal dosing strategies. This becomes even more complex in patients receiving continuous renal replacement therapy (CRRT) because CRRT significantly alters drug clearance. Nonetheless, several PK studies exclude patients undergoing CRRT, and existing studies often suffer from methodological limitations and small sample sizes, which reduce their generalizability. Accordingly, despite the clear clinical need, there remains a critical gap in robust, evidence-based dosing guidelines for antimicrobials in intensive care unit patients receiving CRRT. This executive summary highlights the findings of a published scoping review that mapped the factors influencing antimicrobial PK in critically ill patients receiving CRRT and provides practical recommendations, including a CRRT-PK checklist, for future research.

METHODS: A systematic search of Embase, MEDLINE, and Cochrane databases was conducted from their inception to June 24, 2025. Two independent reviewers performed study selection and data extraction. Data were descriptively synthesized and categorized into CRRT-, patient-, and drug-related factors.

RESULTS: A total of 96 studies were included. This review identified key factors affecting antimicrobial PK during CRRT and provided practical guidance, including a checklist, to support the design and conduct of PK studies in this population.

CONCLUSIONS: This executive summary summarizes a comprehensive scoping review and an accompanying checklist that supports the design of high-quality PK studies in critically ill patients undergoing CRRT, contributing to the development of robust, evidence-based antimicrobial dosing strategies.