The dosage of the drug, which need not be decreased in mild renal failure, is:
a. About 8 - 26% of patients who receive an aminoglycoside for more than several days will develop mild renal impairment that is almost always reversible. Several variables appear to influence the nephrotoxicity from aminoglycosides. Toxicity correlates with the total amount of drug administered.
b. About 60% of administered trimethoprim and from 25 - 50% of administered sulfamethoxazole are excreted in the urine in 24 hours. The rate of excretion and concentrations of both compounds in the urine are significantly reduced in patients with uremia.
c. Permanent impairment of renal function may follow the use of Cotrimoxazole in patients with renal disease, and are reversible decrease in creatinine clearance has been noted in patients with normal renal function.
d. About 50% of ceftriaxone can be recovered from the urine; the remainder appears to be eliminated by biliary secretion.
e. Nephrotoxicity, formerly quite common probably because of less pure concentrations of vancomycin, has become an unusual side effect when appropriate doses are used, as judged by renal function and terminations of the concentration of the antibiotic in blood. Caution must be exercised, however, when other ototoxic or nephrotoxic drugs such as aminoglycosides are administered concurrently, or in patients with impaired renal function.