Excreted Via Flashcards
Natural Penicillins
Renal (unchanged)
Penicillinase resistant penicillin
Renal
Aminopenicillins
Renal (unchanged in urine), need dose adjustment
Anti-pseudomonal penicillins
Renal (unchanged in urine), need dose adjustment
Penicillins + Beta lactamase inhibitors
Renal (unchanged for Co-amox and Sulbactam, metabolites + unchanged for Pip-Tazo), need dose adjustment
1st-5th gen cephalosporins except ceftriaxone
Renal
Ceftriaxone
Hepatic
Carbapnems
Renal (need dose adjustment: Imipenem + Clistatin), the rest also renal but don’t need to adjust
Aztreonam
Renal, need dose adjustment
Vancomycin
Renal, need dose adjustment
Tetracyclines
Renal (Tetracyclines), Unchanged in bile + urine (Doxycyline) and Liver for Minocycline
Tigecyclines
Hepatic (caution only, no need adjustment)
Aminoglycosides
Renal, needs dose adjustments
Macrolides
Hepatic (Erythromycin and Clarithromycin), Unchanged in feces (Azithromycin)
Clindamycin
Hepatic (caution)
Linezolid
Non-enzymatic oxidation to inactive metabolites, no adjustments needed
Fluoroquinolones (Ciprofloxacin + Levofloxacin)
Renal, need dose adjustment
Fluoroquinolones (Moxifloxacin)
Hepatic, need dose adjustments
Sulfonamides
Renal, need dose adjustments
Trimethoprim
Renal, need dose adjustments
Co-trimoxazole
Renal, need dose adjustments
Nitrofurantoin
Renal, no need dose adjust but stop if CrCL < 40mL/min
Amophotericin B
Renal, no mention of dose adjustment although nephrotoxic
5-Flucytosine
Renal, need dose adjustments
Echinocandins
Excreted in urine and feces, non-renally cleared
Azoles (Fluconazole)
Renal, needs dose adjustments
Azoles (Posconazole, Itraconazole and Voriconazole)
P: Feces, I: Liver, V: Liver
Clotrimazole and Miconazole
Absorption is low so not very applicable
Nystatin (Not mentioned)
NIL
Terbinafine
Avoid in severe renal and hepatic dysfunction
