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Metronidazole and its metabolites are mainly excreted via the kidneys (77%) and to a lesser extent via the faeces (14%). [ 7 ] [ 8 ] The biological half-life of metronidazole in healthy adults is eight hours, in infants during the first two months of their lives about 23 hours, and in premature babies up to 100 hours.
The choice of urinary anti-infective agents for patients with renal dysfunction is generally similar to that for individuals with normal kidney function. However, in cases where the patient's glomerular filtration rate (GFR) decreases to less than 20 mL/min, drug dosages adjustment is necessary because achieving the desired therapeutic serum ...
Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function. [1] There are various forms, [2] and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.
Symptoms most often include fever and flank tenderness. [2] Other symptoms may include nausea, burning with urination, and frequent urination. [2] Complications may include pus around the kidney, sepsis, or kidney failure. [3] It is typically due to a bacterial infection, most commonly Escherichia coli. [2]
Oral agents adequate for polymicrobial oral infections include the combinations of amoxicillin plus clavulanate, clindamycin and metronidazole plus a macrolide. Penicillin can be added to metronidazole in the treating dental and intracranial infections to cover Actinomyces spp., microaerophilic streptococci, and Arachnia spp.
The scarring of the small blood vessels, called capillary sclerosis, is the initial lesion of analgesic nephropathy. [7] Found in the renal pelvis, ureter, and capillaries supplying the nephrons, capillary sclerosis is thought to lead to renal papillary necrosis and, in turn, chronic interstitial nephritis.
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Most people will present as nephrotic syndrome, with the triad of albuminuria, edema and low serum albumin (with or without kidney failure). High blood pressure and high cholesterol are often also present. Others may not have symptoms and may be picked up on screening, with urinalysis finding high amounts of protein loss in the urine.
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