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Drug-Induced Kidney Disease Associated With Selected Antibiotics
Abstract:
Structural and functional degeneration of the kidneys occur as the human body ages, making oler people especially susceptible to the consequences of acute kidney injury. Furthermore, the use of nephrotoxic agents, combined with the increased incidence of acute kidney injury and likelihood of an intensive-care unit admission, makes geriatric patients prone to develop drug-induced kidney disease. Vancomycin is routinely used as the first-line treatment for methicillin-resistant Staphylococcus aureus, but is known to be nephrotoxic; studies have shown that an early switch from vancomycin to alternatives does not necessarily prevent renal insult. Therefore, we aim to discuss the mechanisms of drug-induced kidney disease with regard to vancomycin, daptomycin, and ceftaroline and to provide insight as to their safety profiles with regard to older people. A clear understanding of this topic will aid clinicians in selecting drug therapy and may lead to shortened hospital stays, lower hospital costs, and improved outcomes of critically ill older people.
Insights
Older adults are vulnerable to kidney damage from medications like vancomycin. This review examines drug-induced kidney disease mechanisms and safety for geriatric patients, aiding clinical drug selection.
Area of Science:
- Nephrology
- Geriatric Medicine
- Pharmacology
Background:
- Aging kidneys are susceptible to acute kidney injury and drug-induced kidney disease.
- Geriatric patients face increased risks due to comorbidities, intensive care unit (ICU) admissions, and nephrotoxic agent use.
- Vancomycin, a common antibiotic for MRSA, is known for nephrotoxicity, and early switching may not prevent kidney damage.
Purpose of the Study:
- To discuss the mechanisms of drug-induced kidney disease (DIKD) concerning vancomycin, daptomycin, and ceftaroline.
- To provide insights into the safety profiles of these antibiotics in older populations.
- To aid clinicians in selecting appropriate drug therapies for geriatric patients.
Main Methods:
- Literature review and analysis of existing studies on vancomycin, daptomycin, and ceftaroline.
- Examination of nephrotoxicity mechanisms associated with these antibiotics.
- Evaluation of safety data and clinical outcomes in older patients.
Main Results:
- Vancomycin, daptomycin, and ceftaroline possess varying nephrotoxic potentials.
- Specific mechanisms of kidney injury differ among these agents.
- Evidence suggests careful consideration of antibiotic choice is crucial for minimizing renal insult in the elderly.
Conclusions:
- Understanding DIKD mechanisms is vital for optimizing antibiotic selection in older adults.
- Tailoring antibiotic therapy based on individual patient factors and drug safety profiles can improve outcomes.
- Further research is needed to refine treatment strategies and reduce kidney injury in critically ill geriatric patients.