ANTIBIOTICS AND YOUR KIDNEY

IT'S A COMMON SCENARIO..ANOTHER DOCTOR OR YOUR DENTIST HANDS YOU A PRESCRIPTION FOR AN ANTIBIOTIC. YOU WORRY HOW IT WILL ALL EFFECT NEXT WEEK'S LABWORK AND YOUR CREATININE LEVEL. ARE YOU CORRECT IN BEING WORRIED? THAT'S THE QUESTION WE POSED TO ONE OF OUR KIDNEY EXPERTS. "THAT DEPENDS ON A FEW THINGS"SAYS DR. GABRIEL VALLE OF THE KIDNEY GROUP,"ITS NOT ALWAYS A SIMPLE ANSWER." WHEN PRESSED TO EXPLAIN WHAT A PATIENTS IS THEN TO DO DR. VALLE SAID"FIRST, EVERY PATIENT OF OUR PRACTICE IS TOLD ON THE FIRST VISIT THAT THEY ARE TO HENCEFORTH TELL ALL MEDICAL AND DENTAL PERSONS THEY ENCOUNTER THAT THEY HAVE CHRONIC KIDNEY DISEASE. WE ENCOURAGE YOU TO KNOW AND UNDERSTAND YOUR STAGE OF DISEASE. THEN IT IS FAIRLY SIMPLE AND STRAIGHTFORWARD FOR YOUR OTHER DOCTORS TO CHOOSE DRUGS NOT 100% EXCRETED BY THE KIDNEYS. THERE ARE SOME CLASSES OF ANTIBIOTICS BEST AVOIDED ALTOGETHER. SOMETIMES YOU HAVE NO CHOICE BUT TO USE A DRUG THAT CAN BE HARMFUL. IN THESE CASES THE DOSE HAS TO BE ADJUSTED FOR THE LEVEL OF RENAL FAILURE." DR. VALLE WENT ON TO EXPLAIN THAT A GOOD INTERNIST CAN MODIFY THE DOSE AS HE PRESCRIBES IT. "OFTEN THE NEED TO LOWER THE DOSE IS PICKED UP BY THE PHARMACIST WHO KNOWS THE PATIENT'S HISTORY. WE DO FIELD A LOT OF CALLS REGARDING DOSES FROM DENTISTS AND THIS IS UNDERSTANDABLE. IT IS NOT UNCOMMON FOR THE TREATING PHYSICIAN TO ASK FOR OUR INPUT. MOST IMPORTANT IS THE PATIENT WHO KNOWS AND UNDERSTANDS HIS LEVEL OF CHRONIC KIDNEY DISEASE-HIS STAGE-AND MAKES SURE ALL HIS HEALTH CARE PRACTITIONERS UNDERSTAND AS WELL." DR. VALLE ALSO SAID "IT IS IMPORTANT FOR PATIENTS TO KNOW THAT NOT EVERY FLU WARRANTS AN ANTIBIOTIC. MANY CASES OF THE FLU OR COMMON COLD DO NOT REQUIRE AN ANTIBIOTIC THAT MAY HAVE DELETERIOUS EFFECTS. A GOOD DOCTOR WILL NOT WRITE THE PRESCRIPTION JUST BECAUSE THE PATIENT WANTS IT." POINT WELL TAKEN. FIRST DO NO HARM.