Treatment of E. coli UTI in Patients with Impaired Renal Function

Medication Selection and Dosing

• For patients with impaired renal function, dose adjustment is necessary for fluoroquinolones, such as levofloxacin and ciprofloxacin, with the Infectious Diseases Society of America recommending adjusted dosing for patients with renal impairment 1, 2
• The recommended dosing for levofloxacin in patients with creatinine clearance 50-80 mL/min is a 500 mg loading dose, then 250 mg every 24 hours, according to the Clinical Infectious Diseases guidelines 1, 2

Monitoring Considerations

• Monitoring of renal function during treatment with fluoroquinolones is recommended, as they can occasionally cause acute renal failure, with a strength of evidence level of moderate 2

Ciprofloxacin Dosing in Patients with Renal Impairment

Dosing Recommendations

• For patients with creatinine clearance 30-50 mL/min, the Infectious Diseases Society of America recommends ciprofloxacin dosing at 250-500 mg every 12 hours 3
• The Infectious Diseases Society of America guidelines confirm that dose adjustment is necessary for ciprofloxacin in patients with renal impairment, with specific dosing information available in the IDSA HIV/CKD guidelines 3