chronic renal insufficiency due to long-standing d - stefan78

[ArchivalUser]

A 61-year-old woman with chronic renal insufficiency due to long-standing diabetes mellitus comes to the office with a fever, cough, shaking chills, and fatigue. She has long-standing diabetes mellitus with her last hemoglobin A1C being 9.1%, BUN 51 mg/dL, and creatinine 2.1 mg/dL. A chest radiograph demonstrates a right lower lobe infiltrate. Oral antibiotics are prescribed for the patient. The most correct statement concerning a diabetic patient with an infectious process is:

A. Antimicrobial dosing must be adjusted due to decreased liver function


B. Antimicrobial dosing must be adjusted due to decreased renal function


C. Diabetics have the same epidemiology of pulmonary infections as non-diabetics


D. It is more common for diabetics to have lower lobe pneumonia when compared to non-diabetics


E. Oral antibiotics are not efficacious for treating pneumonia in diabetics

[ArchivalUser]

BBB

[ArchivalUser]

b

[ArchivalUser]

b--

[ArchivalUser]

bbbbbbbbbb

[ArchivalUser]

The correct answer is B. All drugs (substances in general) are eliminated from the body by means of either renal or hepatic clearance or both. This is one of the most important concepts known by physicians. Almost every patient that presents to inpatient medical services today has some impairment of one or both of these mechanisms. This must be kept in mind when prescribing any drug. In the case of this patient, renal antibiotic dosing schedules for variable renal function are available to every student and house officer and should be consulted regularly. This patient has a creatinine of 2.1 mg/dL, reflecting abnormal renal function.