Antibiotic therapy in renal insufficiency

To simplify the antibiotic therapy for patients with renal insufficiency we devide the antibiotics into 3 categories. The first is the "chloramphenicol category" where all drugs like chloramphenicol are mainly metabolized and almost not renal excreted in active form. The second is the "mixed category" where the antibiotics are either renal excreted and metabolized. And the third is the "penicillin category" where drugs are mainly renal excreted without metabolization. Where as drugs like chloramphenicol must be given in normal dosage there is a dose reduction necessary for the other two typs. Tables are offered and explained how these dose reductions were established and how to use them. To define the renal function we use the plasma creatinine or even better formulas where you need the plasma creatinine and other patient related data (age, sex, height, weight) to approximately estimate the glomerular filtration rate. Because of the persisting high plasma concentrations of antibiotics in patients with end-stage renal insufficiency we can achieve therapy results which are not possible with the "normal" antibiotic treatment. There are given advices to treat the most important infections in dialysis patients. It is very important to control the treatment by clinical examination, fever and CRP if necessary daily.