Background: Optimal dose of antibiotics is crucial for the effective treatment of an infection. Though appropriate dosing in renal patients is usually difficult and is subject to dosing errors for different factors. Nevertheless, these types of dosing errors and considerations in renal patients are controversial. Objective: This study aims at evaluating the renal impairment of different levels (including at-risk) in relation to antibiotic dosing and dosing errors. Method: the literature was examined through Medline, PubMed, Embase, and Ovid database in 2010 and 2020. Searching terms included were a combination of “renal” OR “kidney” AND “impairment” OR “injury” AND “Antibiotic” AND “dos*” AND “errors." Following this, results were refined to include only original research articles investigating antibiotic dosing considerations or errors in patients with varying renal impairment levels in different care settings. Selected trials mentioned the types of antibiotics and the degree of renal impairment. Result: A total of 1902 articles were returned. After the exclusion of articles on animals and including only studies on humans, 32 studies were found. A total of nine articles were identified as eligible, covering 5591 patients who had prescribed antibiotics in different care settings and with variable levels of renal impairment. Two of the included studies were pharmacokinetic models, while the other two were prospective observational studies and the remaining five studies were retrospective. Conclusion: Dosing of antibiotics in renal impairment patients or those at risk of renal impairment needs to be individualized and depend on appropriate choice of equations to calculate creatinine clearance based on the level of renal impairment.

Renal impairment, antibiotics, dosing errors, optimal dosing