Mechanisms of antimicrobial-induced nephrotoxicity in children.

The Journal of Antimicrobial Chemotherapy
Kevin J DownesAthena F Zuppa

Abstract

Drug-induced nephrotoxicity is responsible for 20% to 60% of cases of acute kidney injury in hospitalized patients and is associated with increased morbidity and mortality in both children and adults. Antimicrobials are one of the most common classes of medications prescribed globally and also among the most common causes of nephrotoxicity. A broad range of antimicrobial agents have been associated with nephrotoxicity, but the features of kidney injury vary based on the agent, its mechanism of injury and the site of toxicity within the kidney. Distinguishing nephrotoxicity caused by an antimicrobial agent from other potential inciting factors is important to facilitate both early recognition of drug toxicity and prompt cessation of an offending drug, as well as to avoid unnecessary discontinuation of an innocuous therapy. This review will detail the different types of antimicrobial-induced nephrotoxicity: acute tubular necrosis, acute interstitial nephritis and obstructive nephropathy. It will also describe the mechanism of injury caused by specific antimicrobial agents and classes (vancomycin, aminoglycosides, polymyxins, antivirals, amphotericin B), highlight the toxicodynamics of these drugs and provide guidance on administr...Continue Reading

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Citations

Feb 19, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Amrit KirpalaniMina Matsuda-Abedini
Feb 5, 2021·Clinical Pharmacology and Therapeutics·Kevin J Downes, Jennifer L Goldman
Mar 7, 2021·The Journal of Antimicrobial Chemotherapy·Sarah C J JorgensenBruce R Dalton
Apr 24, 2021·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Lucas Alexandre de Mello GoldinVinicius Daher Alvares Delfino
May 7, 2021·European Journal of Pediatrics·Rumeysa YalçınkayaGönül Tanır
May 15, 2021·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association·Chen GaoZhihui Hao
Aug 24, 2021·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Hannah LuNicholas M Fusco

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