Table 1 The survey results

Demographic characteristics

  What is your medical qualification?

  Critical care medicine

77/157 (49)

  Anesthesiology

61/157 (39)

  Pulmonology

5/157 (3)

  Nephrology

5/157 (3)

  Emergency

4/157 (3)

  Internal medicine

2/157 (1)

  Cardiology

2/157 (1)

  Infectious disease

1/157 (1)

  For how many years have you worked in an ICU (years, median [IQR])

10 [4-18]

In which type of institution do you work?

  University hospital

78/157 (50)

  Public-sector general hospital

71/157 (45)

  Private-sector for-profit or non-profit hospital

8/157 (5)

CRRT practices

Which RRT modality do you most commonly use?

  Continuous renal replacement therapy

110/157 (70)

  Intermittent renal replacement therapy

47/157 (30)

Which CRRT techniques do you use?

  Continuous venovenous hemofiltration

114/157 (71)

  Continuous venovenous hemodialysis

89/157 (57)

  Continuous venovenous hemodiafiltration

87/157 (55)

  Sustained Low-Efficiency Dialysis

13/157 (8)

Which is the most commonly used CRRT technique?

  Continuous venovenous hemofiltration

81/156 (52)

  Continuous venovenous hemodialysis

54/156 (35)

  Continuous venovenous hemodiafiltration

21/156 (13)

  Which is the most commonly used anticoagulant?

  Citrate

100/157 (64)

  Heparin

57/157 (36)

If you use continuous venovenous hemofiltration or hemodiafiltration, which hemofiltration mode do you prefer?

  Postdilution mode

22/142 (16)

  Predilution mode

11/142 (8)

  Pre/postdilution mode

106/142 (77)

Which is the most commonly used CRRT dose, and how do you adjust it?

  20 mL/kg/h

9/157 (6)

  25 mL/kg/h

36/157 (23)

  30 mL/kg/h

49/157 (31)

  35 mL/kg/h

45/157 (29)

  2000 mL/h (effluent flow not adjusted for body weight)

12/157 (8)

  2500 mL/h (effluent flow not adjusted for body weight)

3/157 (2)

  3000 mL/h (effluent flow not adjusted for body weight)

3/157 (2)

  Dialysis dose adjusted for body weight upon CRRT initiation

29/75 (39)

  Dialysis dose adjusted for body weight on admission

27/75 (36)

  Dialysis dose adjusted for ideal total weight

19/75 (25)

Which type(s) of membrane do you use for CRRT?

  Polysulfone (Fresenius® kits: CVVHDF 600, CVVHDF 1000, CVVH 600, CVVH 1000, HV-CVVH 1000, Ci-Ca postCVVHDF 1000, Ci-Ca CVVHD 1000, Ci-Ca EMiC2 ; Theradial® kits: Aquamax HF12, HF 19)

54/138 (39)

  Polyarylethersulfone (Baxter® kits: Prismaflex HF1000, HF1400)

9/138 (7)

  Acrylonitrile (Baxter® kits: Prismaflex M100, M150)

29/138 (21)

  Acrylonitrile coated with polyethylenimine (Baxter® kits: Prismaflex ST100, ST150)

55/138 (40)

Beta-lactam dosing regimens during CRRT

  Which beta-lactam dosing regimen do you prescribe for patients on CRRT?

  Unadjusted dosing regimens

88/157 (56)

  Full dose for 24 h and then a reduced-dosing regimen

26/157 (17)

  Full dose for 48 h and then a reduced-dosing regimen

14/157 (9)

  A single loading dose before a reduced-dosing regimen

20/157 (13)

  Reduced-dosing regimens all the time

3/157 (2)

  Reduced or full doses, depending on the drug compound

6/157 (4)

Do you adjust the antibiotic dose based on the dialysis dose or effluent flow?

  Yes

23/154 (15)

  No

131/154 (85)

Do you use prolonged/continuous infusions for beta-lactams in patients on CRRT?

  Yes

138/157 (88)

  No

19/157 (12)

If yes, for which beta-lactam?

  Piperacillin/tazobactam

108/119 (91)

  Cefotaxime

63/119 (53)

  Ceftazidime

85/119 (71)

  Cefepime

59/119 (50)

  Meropenem

47/119 (40)

If yes, which tools do you use?

  Guide Prescription et Rein (French renal prescription handbook)

103/139 (74)

  Therapeutic drug monitoring

86/139 (62)

  Data from clinical studies in the literature

48/139 (35)

  Dosing regimens of patients with renal failure applied to the estimated creatinine clearance rate of the patient on RRT

6/139 (4)

  Pharmacokinetic software

4/139 (3)

  Pharmacokinetic calculations by hand

3/139 (2)

  Other tools

6/139 (4)

If beta-lactam therapeutic drug monitoring is used, which pharmacokinetic/pharmacodynamic target do you use?

  40/50/70% T > MIC

0/74 (0)

  100% T > MIC

12/74 (16)

  40/50/70% T > 4 MIC

4/74 (5)

  100% T > 4 MIC

39/74 (53)

  40/50/70% T > 5 MIC

0/74 (0)

  100% T > 5 MIC

7/74 (10)

  40/50/70% T > 8 MIC

0/74 (0)

  100% T > 8 MIC

12/74 (16)

Do you sometimes call other specialists for advice on antibiotic dosing regimen adjustment for patients on CRRT?

  No

92/157 (59)

  Infectious disease specialist

45/157 (29)

  Microbiologist

16/157 (10)

  Pharmacist/pharmacologist

13/157 (8)

  Nephrologist

8/157 (5)

  Toxicologist

8/157 (5)

For a 70 kg patient admitted with community-acquired infectious pneumonia and treated with your preferred CRRT technique at 25 ml/kg/hour, which maintenance dose do you prescribe for cefotaxime?

  2 g TID

84/156 (54)

  2 g BID

17/156 (11)

  1 g TID

44/156 (28)

  1 g BID

9/156 (6)

  1 g QID

2/156 (1)

For a 70 kg patient admitted with hospital-acquired infectious pneumonia and treated with your preferred CRRT technique at 25 ml/kg/hour, which maintenance dose do you prescribe for piperacillin/tazobactam?

  4/0.5 g QID

61/154 (40)

  4/0.5 g TID

69/154 (45)

  4/0.5 g BID

15/154 (10)

  3/0.375 g QID

6/154 (4)

  Other

2/154 (1)

For a 70 kg patient admitted with hospital-acquired infectious pneumonia and treated with your preferred CRRT technique at 25 ml/kg/hour, which maintenance dose do you prescribe for meropenem?

  2 g TID

48/156 (31)

  2 g BID

9/156 (6)

  1 g TID

69/156 (44)

  1 g BID

28/156 (18)

  Other

2/156 (1)

Does your institution have procedures for adjusting antibiotic doses in patients on CRRT?

  Yes

33/157 (21)

  No

124/157 (79)

Do you feel that you observe more beta-lactam-induced neurotoxicity in patients treated with renal replacement than in other patients?

  Fully agree

5/157 (3)

  Tend to agree

48/157 (31)

  Tend to disagree

80/157 (51)

  Strongly disagree

24/157 (15)