Administration of Bactrim in Dialysis Patients

Rationale for Post-Dialysis Administration

• The American Thoracic Society recommends that in general, antibiotics should be given after hemodialysis to avoid any loss of the drugs during the dialysis process 2
• Administering medications after dialysis prevents premature removal of the drug, which would lead to subtherapeutic levels and potentially inadequate treatment 1

Dosing Recommendations

• For patients with creatinine clearance <30 mL/min or those receiving hemodialysis, the American Thoracic Society recommends increasing the dosing interval rather than decreasing the dose 2
• Standard dosing of antibiotics is inappropriate for patients with end-stage renal disease as it can lead to drug accumulation and toxicity 1

Common Pitfalls to Avoid

• Do not administer Bactrim before dialysis sessions, as this would lead to premature removal of the drug 1
• Do not use standard dosing regimens for patients on dialysis without appropriate adjustments to the dosing interval 2
• Avoid excessive accumulation of the drug by properly spacing doses according to the degree of elimination impairment 3