Metronidazole Dosing in Elderly Patients with CKD Stage 3

Pharmacokinetic Basis

• Metronidazole is cleared predominantly by hepatic metabolism rather than renal excretion, distinguishing it from many drugs that require dose reduction in renal impairment. 1, 2, 3

Guideline Evidence

• Current guideline reviews of renally cleared medications in older adults with chronic kidney disease do not list metronidazole as a drug needing dose adjustment, thereby supporting the use of standard adult dosing in patients with eGFR 30–59 mL/min/1.73 m². 1, 2, 3