Final answer:
TB's creatinine clearance (CrCl) is calculated using the Cockcroft-Gault formula, yielding a result of 33.42 mL/min. Considering her CrCl and condition, it is recommended to consult a pharmacist for proper dosing and antibiotic selection to avoid nephrotoxicity and optimize treatment effectiveness while preventing resistance.
Step-by-step explanation:
The patient TB's creatinine clearance (CrCl) can be calculated using the Cockcroft-Gault formula which requires the patient's age, weight, serum creatinine (SCr), and gender. The formula for females is: ((140 - age [years]) × weight [kg]) / (72 × SCr [mg/dL]) × 0.85. First, we convert TB's weight into kilograms: 200 lbs / 2.2 = approximately 91 kg. Then we apply the formula: ((140 - 76) × 91) / (72 × 1.6) × 0.85. This gives us a CrCl of 33.42 mL/min.
Given her CrCl and the complexity of TB's case, including her age and the complication with an abscess, it is important to consult with a pharmacist to ensure that the dosing regimen of piperacillin/tazobactam is appropriate. Adjustments may be needed based on CrCl to avoid potential nephrotoxicity and optimize efficacy. Piperacillin/tazobactam's dosing often requires modification in patients with reduced renal function, and following guidelines such as those provided by the manufacturer or other clinical resources is essential. Additionally, as antimicrobial stewardship is crucial to prevent resistance, confirming the appropriateness of the antibiotic selection given the microbiological landscape and patient's history is recommended.