is an important consideration when using antibiotics.
However, renal function is often overestimated in the
elderly, because their typical gradual loss of muscle mass
causes creatinine clearance to decrease with age, whereas
serum creatinine concentration remains relatively stable
[4–9]. Because vancomycin and aminoglycosides are
eliminated from the body mainly via the kidneys, overestimation
of renal function leads to increased trough concentrations,
which may result in nephrotoxicity [10–14].
The most common infections in older adults are bacterial
pneumonia, urinary tract infection (UTI), skin and soft
tissue infection, and septicemia of unknown origin [15, 16].
Most therapeutic guidelines for infectious disease recommend
treatment with anti-microbial agents for such conditions
[17–23]. Therefore, the elderly are especially prone
to renal failure caused by overdose and long-term use of
antimicrobial agents.
The administration of antimicrobial agents to the elderly
is associated with several potential difficulties: AKI associated
with overdosage, repeated and long-term administration
for chronic infections such as aspiration pulmonary
disease and complex UTI, and polypharmacy-related drug–
drug interactions. This review discusses drug-induced AKI,
drug interactions and ADRs associated with antimicrobial
agents, and potential strategies to increase awareness of
AKI risk factors and to mitigate the clinical effects of AKI