大多数抗菌药物自体内的清除主要通过肾脏排泄,其代谢产物也多由肾脏排出。因此,肾损时将影响药物及其代谢产物的清除,使药物在体内蓄积,导致药物毒性反应的发生。现谈谈肾损时抗菌药物应用的体会。1 肾损时仍给正常剂量者 此类药物包括主要经肝代谢或肝胆系统排泄的抗菌药物。在肾损时血药浓度增高和血清半衰期延长皆不显著,其中某些药物的毒性也较小。如红霉素、麦迪霉素、利福平、强力霉素、新生霉素、酮康唑、克霉唑等。2 肾损时药物剂量略予调整者 有青霉素类抗生素,由肝胆系统排泄较多的头孢哌酮、头孢三嗪,以及在体内代谢的头孢噻吩、头孢噻肟等。某些氟喹诺酮类(环丙沙星、依诺沙星等),主 Most of the antimicrobial drug clearance from the body mainly through the kidneys, and its metabolites are mostly excreted by the kidneys. Therefore, renal damage will affect the clearance of drugs and their metabolites, the accumulation of drugs in the body, leading to the occurrence of drug toxicity. Now talk about the anti-bacterial application of kidney injury experience. 1 renal damage is still given to the normal dose of such drugs, including mainly by liver metabolism or liver and gallbladder system excretion of antimicrobial drugs. Renal damage in the blood concentration and serum half-life prolongation are not significant, some of which are less toxic. Such as erythromycin, midecamycin, rifampin, doxycycline, novobiocin, ketoconazole, clotrimazole and so on. 2 renal damage when the drug dose slightly adjusted who have penicillin antibiotics, excretion by the hepatobiliary system cefoperazone, ceftriaxone, and in vivo metabolism of cephalothin, cefotaxime and so on. Some fluoroquinolones (ciprofloxacin, enoxacin, etc.), the main