Amikacin and vancomycin are the other antibiotics that require dose reduction in renal failure. Newer antibiotics are often used instead of aminoglycosides to reduce the risk of renal damage.
Because of reduced renal excretion, aminoglycosides require dosage modification in patients with renal failure. The traditional concept of conventional post-dialysis dosing in patients on hemodialysis needs to be revised in favor of higher predialysis doses to maintain effective bactericidal activity. Regular monitoring of serum level and adjustment of doses accordingly is necessary, and this is particularly relevant in patients undergoing continuous renal replacement therapy to maintain optimum bactericidal efficacy.