Sunday, September 29, 2019

cephalosporins and renal insuff

Q: Which of the following cephalosporins does not need any dose adjustment in renal insufficiency/failure? 

A) Cefazolin
B) Cefotaxime
C) Ceftriaxone
D) Ceftazidime
E) Cefepime

Answer: C

The objective of above question is to highlight two important facts regarding ceftriaxone. This is the only cephalosporin which does not require renal adjustment. Its elimination half-life and plasma clearance does not correlate linearly with creatinine clearance. Also, ceftriaxone is the only drug which does note get removed via hemodialysis.

This is true till ceftriaxone dosage stays 2 grams or less per day.



1.  Patel IH, Sugihara JG, Weinfeld RE, Wong EG, Siemsen AW, Berman SJ. Ceftriaxone pharmacokinetics in patients with various degrees of renal impairment. Antimicrob Agents Chemother. 1984;25(4):438–442. 

2. Livornese LL Jr, Slavin D, Gilbert B, Robbins P, Santoro J. Use of antibacterial agents in renal failure. Infect Dis Clin North Am 2004;18:556–67 

3. Aronoff GR. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults. 4th ed. Philadelphia, Pa.: American College of Physicians, 1999.

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