From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For patients with end-stage renal disease (ESRD), peripheral intravenous (IV) lines are generally acceptable for antibiotic administration, with central venous catheters (CVCs) being appropriate for longer-term therapy. However, it's crucial to avoid using existing hemodialysis access sites such as arteriovenous fistulas (AVFs), arteriovenous grafts (AVGs), or tunneled dialysis catheters for antibiotic administration unless absolutely necessary in emergency situations. These access sites are lifelines for ESRD patients and must be preserved. When administering antibiotics to ESRD patients, dose adjustments are typically required based on the specific antibiotic's clearance properties and the patient's residual renal function, as noted in studies such as 1 and 2. Many antibiotics like vancomycin, aminoglycosides, and beta-lactams require significant dose reductions or extended dosing intervals. Additionally, timing antibiotic administration in relation to dialysis sessions is important, as some antibiotics may be removed during hemodialysis, a consideration highlighted by research including 3 and 4. For patients receiving intermittent hemodialysis, antibiotics are often administered after dialysis sessions to prevent premature clearance of the medication. This approach helps maintain therapeutic drug levels while avoiding toxicity in these vulnerable patients. Key considerations include:
- Avoiding the use of hemodialysis access sites for antibiotic administration
- Adjusting antibiotic doses based on the patient's residual renal function and the antibiotic's clearance properties
- Timing antibiotic administration in relation to dialysis sessions to prevent premature clearance
- Using peripheral IV lines or CVCs for antibiotic administration when possible, as suggested by 1 and 2.