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Antibiotic Dose Adjustment CKD — ESENeph MCQ

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EasyChronic Kidney DiseaseAntibiotic Dose Adjustment CKDESENeph

A 65-year-old man with CKD G4 (eGFR 18) is prescribed Co-amoxiclav for a lower respiratory tract infection. The GP prescribes the standard adult dose. Should the dose be adjusted?

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Correct answer: B — Co-amoxiclav requires dose interval extension in severe CKD (eGFR <30) – typically reduce frequency rather than individual dose; check BNF for specific renal dosing

Many antibiotics require dose adjustment in CKD. For Co-amoxiclav in eGFR <30: the BNF recommends dose interval extension (e.g. 625 mg BD instead of TDS for moderate infections). The Amoxicillin component is renally cleared and accumulates. Clavulanic acid is less affected. Not all antibiotics need adjustment – Azithromycin, Doxycycline, and Clindamycin do not require renal dose changes. Checking the BNF or local renal drug dosing handbook before prescribing any medication in CKD is essential.

Reference: BNF 2024 – Co-amoxiclav; KDIGO 2024 – CKD (Drug Stewardship)