[Antibiotics dosing strategies in chronic kidney disease]

Patients with chronic kidney disease (CKD) are at high-risk for adverse drug reactions and drug-drug interactions. Drug dosing in these patients often proves to be a difficult task. Renal dysfunction-induced changes in human pathophysiology may alter medication pharmacokinetic parameters like absorption, distribution, metabolism and elimination of antibiotics. In general, drug dosing is accomplished by reducing the dose or increasing the dosing interval. Both methods can be used simultaneously. Some antibiotics are to be avoided in CKD because of lack of efficacy or increased risk of toxicity. Specific recommendations are available for helping dosing of antibiotics.