Augmentin Use in Renal Transplant Patients: Monitoring and Precautions

Monitoring Renal Function

• The National Kidney Foundation recommends frequent creatinine monitoring to guide antibiotic dosing in transplant recipients, with monitoring daily for the first 7 days or until hospital discharge, 2-3 times weekly for weeks 2-4, weekly for months 2-3, every 2 weeks for months 4-6, monthly for months 7-12, and every 2-3 months thereafter 1
• Any decline in kidney function during Augmentin therapy warrants immediate evaluation to distinguish between drug nephrotoxicity, rejection, or infection-related changes, as recommended by the National Kidney Foundation 1

Drug Interactions with Immunosuppression

• The American Society of Transplantation recommends monitoring calcineurin inhibitor (CNI) levels when starting or stopping Augmentin, as changes in renal function or drug interactions may affect immunosuppressant concentrations 1
• The American Society of Transplantation advises measuring CNI blood levels whenever there is a change in medication or patient status that may affect blood levels, and whenever there is a decline in kidney function that may indicate nephrotoxicity or rejection 1