Nephrotoxic antibiotic use among patients with chronic kidney disease

Objectives Patients with chronic kidney disease (CKD) are at an increased risk of infections, necessitating frequent antibiotic use. However, inappropriate use can lead to adverse outcomes, including nephrotoxicity. The objective of the study were to determine the prevalence and describe the prescribing patterns of nephrotoxic antibiotics, identify predictors of nephrotoxicity, evaluate the impact of nephrotoxic antibiotic exposure on renal function, and provide evidence-based recommendations for optimizing antibiotic use and reducing nephrotoxicity in patients with CKD. Material and Methods A retrospective longitudinal study was conducted at a secondary healthcare facility in Nigeria. Data on demographics, comorbidities, creatinine, and antibiotic prescriptions were collected and analyzed. Nephrotoxicity predictors were evaluated using logistic regression, and the impact on renal function was assessed using the Mann-Whitney test at a statistically significant level of p < 0.05. Results The prevalence of potentially nephrotoxic antibiotics was 88.7% (n = 173). Overall, ceftriaxone (81, 40.7%) was the most prescribed, followed by ciprofloxacin (53, 26.6%). Concurrent use of two antibiotics was significantly associated with nephrotoxicity [Adjusted odds ratio (AOR), 3.30; 95% confidence interval (CI), 1.05–10.30]. Conclusion The high prevalence of nephrotoxic antibiotics and associated nephrotoxicity among patients with CKD highlights the need for targeted antimicrobial stewardship.