Renal and electrolyte complications associated with antibiotic therapy

Adverse effects of antibiotics generally are minimal, but it is necessary to remain vigilant for potentially serious sequelae, such as unusual forms of renal failure, acidosis and electrolyte abnormalities. Avoiding potentially nephrotoxic drug combinations and monitoring drug levels of nephrotoxic agents such as vancomycin and aminoglycosides should be routine. However, with prolonged use of certain antibiotics, levels of electrolytes, creatinine and blood urea nitrogen should be periodically checked. Elderly and debilitated patients or patients with preexisting renal insufficiency are at particularly high risk for unexpected complications from antimicrobial therapy. All antibiotics have the potential to cause acute interstitial nephritis, which may be manifested by acute renal failure.