Antibiotic doses in renal impairment

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Antibiotic doses in renal impairment.

The following antibiotics require dose adjustment in patients with reduced renal function. Recommendations are based on the patient's current creatinine clearance (CrCl), which is used as an estimate of kidney function for the purposes of drug dosing.

Many elderly patients have a CrCl below 50ml/min, which, because of reduced muscle mass, may not be indicated by a raised creatinine level. It is therefore especially important to calculate the CrCl as outlined above for this patient group (especially when prescribing Gentamicin).

Anuric and oliguric (<500ml/day) patients can be assumed to have a

Crcl < 10ml/min (severe renal impairment).

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).