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Cephalosporin-induced nephrotoxicity: does it exist?

G G Zhanel1

  • 1Faculty of Pharmacy, University of Manitoba, Winnipeg, Canada.

DICP : the Annals of Pharmacotherapy
|March 1, 1990
PubMed
Summary

Certain cephalosporins, like cephaloridine and cephalothin, can cause kidney damage (nephrotoxicity), especially with aminoglycosides. Other cephalosporins generally do not increase this risk.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Cephalosporins are widely used antibiotics.
  • Nephrotoxicity is a potential adverse effect of some medications.
  • Concomitant therapy with aminoglycosides can alter drug toxicity profiles.

Purpose of the Study:

  • To review existing literature on cephalosporin-induced nephrotoxicity.
  • To evaluate the impact of concurrent aminoglycoside administration on this risk.

Main Methods:

  • Literature review of animal and human studies.
  • Analysis of data on various cephalosporin agents.
  • Assessment of combination therapy effects.

Main Results:

  • Cephaloridine and cephalothin are implicated in nephrotoxicity, alone and with aminoglycosides.
  • Limited evidence suggests other cephalosporins rarely cause nephrotoxicity.
  • Ceftazidime-induced nephrotoxicity observed in patients with renal impairment.
  • Cefazolin shows animal nephrotoxicity but not reported in humans.
  • Other cephalosporins do not increase aminoglycoside nephrotoxicity risk.

Conclusions:

  • Cephaloridine and cephalothin pose a nephrotoxicity risk.
  • Ceftazidime requires dosage adjustment in renally impaired patients.
  • Most cephalosporins appear safe regarding nephrotoxicity, especially with aminoglycosides.

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