Cephalosporins renal disease

They are widely distributed after administration throughout body fluids. Cephalosporins are mainly excreted by the kidneys and dose should be altered in patients with renal disease. 

Most instance of drug-induced renal disease are probably due to direct toxicity. Even cephalosporins such as cephalothin or cephaloridin, which can produce immunological reactions, more frequently damage the kidney directly (Parker 1979 a). 

The older adult is more susceptible to the nephrotoxic effects of the cephalosporins particularly if renal function is already diminished because of age or disease. If renal impairment is present, a lower dosage and monitoring of blood creatinine levels are indicated. Bood creatinine levels greater than 4 mg/dL indicate serious renal impairment. In elderly patients with decreased renal function, a dosage adjustment may be necessary. 

Renal function impairment Cephalosporins may be nephrotoxic use with caution in the presence of markedly impaired renal function (Ccr less than 50 mL/min/1.73 m ). Hepatic function impairment Cefoperazone is extensively excreted in bile. Serum half-life increases 2-fold to 4-fold in patients with hepatic disease or biliary obstruction. 

Decreased renal function affects the elimination of most third-generation cephalosporins, whereas the presence of hepatic disease does not require dose adjustment. 

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