Antibiotics, like any other medication, require dose adjustment in cases of kidney dysfunction. Several factors influence the decision regarding dose adjustment.

For instance, if a patient is in sepsis, it is advisable not to adjust the antibiotics within the first 24 to 48 hours of initiating treatment. Furthermore, not every increase in serum creatinine indicates kidney dysfunction; it could be a temporary rise due to dehydration. In such cases, it is essential to assess the urea-creatinine ratio.

The primary consideration is to confirm the presence of kidney dysfunction before considering dose adjustment. Subsequently, adjustments should be made accordingly.

Additionally, it’s worth noting that some medications’ dosages for certain patients are determined based on serum creatinine levels, irrespective of kidney dysfunction. For example, kidney function-based dosing of vancomycin for neonates.