U níže uvedených antibiotik je nezbytné upravit dávkování při snížené funkci ledvin. Doporučená úprava vychází z hodnot pacientovy clearence kreatininu (CrCl), která se při dávkování léků k odhadu úrovně funkce ledvin používá.
Starší pacienti mohou mít hodnoty CrCl pod 50ml/min, což však vzhledem k redukované svalové hmotě nemusí znamenat vzestup hladiny kretininu. Proto je důležité It is therefore especially important to calculate the CrCl as outlined above for this patient group (especially when prescribing Gentamicin).
Cockcroft-Gault CrCl estimates (using the creatinine clearance calculator) should be used for drug dosing rather than the automated MDRD eGFR produced by the clinical chemistry laboratory available on NOTIS.
Click on the antibiotic for details of each dose adjustment
A | B | C | D | E | F | G | H | I | J | K | L | M
N | O | P | Q | R | S | T | U | V | W | X | Y | Z
The full guideline in PDF (Nottingham Hospitals Guideline on antibiotic doses in renal impairment) has been registered with the Trust and can be accessed by clicking here. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt, contact a senior colleague or expert. Caution is advised when using guidelines after the review date (March 2011).
Refer to renal pharmacist for advice on dosing in haemodialysis and peritoneal dialysis.
Refer to critical care pharmacist for advice on dosing in CVVH.
Amoxicillin (IV Ampicillin no longer available at NCH)
Amphotericin - (Abelcet and Ambisome)
Piperacillin/tazobactam (Tazocin)
Sodium fusidate (Fusidic acid)