Which antibiotics are safe for pneumonia during dialysis?

Question

Hello doctor,

My brother has CKD and is on dialysis three times a week. He recently got pneumococcal disease, and we are worried about how this might affect his kidneys. He is 46 and already deals with weakness, but now he is even more tired and not eating well. Are the antibiotics for pneumococcal infection safe for CKD patients? Should we be looking for specific treatments that should not strain his kidneys?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Most medications are excreted by the kidneys. He still needs to take antibiotics for the pneumonia. Also, he should continue his dialysis sessions, and we will be certain that any medications will be flushed out during dialysis.

The Probable Causes: Hospital-acquired pneumonia.

Investigations to be done:

Chest X-ray.
Sputum M/C/S (microscopy, culture, and sensitivity) test.
Electrolyte test.
Urea and creatinine.
Complete blood count.
ESR (erythrocyte sedimentation rate).

Differential diagnosis: HAP community-acquired pneumonia.

Probable diagnosis: Pneumonia in a background patient with CKD (chronic kidney disorder).

Treatment plan:

Oral Amoxiclav 1 g 12 hourly for one week.
Oral Azithromycin 500 mg daily for 3 days.

Regarding follow-up:

Ensure to complete antibiotics.
Also, ensure dialysis is done.
The liver also metabolizes drugs, so the kidneys do not do all the work of removing drugs.

Preventive measures:

Pneumococcal vaccine.
Influenza vaccine.
Ensure cough etiquette.
Good hygiene.
Eat fruits and vegetables.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.