Relationship between Nephrotoxic and Antibiotics

Abstract

Typically the nephrotoxic beta-lactam antibiotics trigger acute proximal tubular necrosis. Significant renal toxicity, which has been rare with the penicillin’s and uncommon with the cephalosporins, is a greater risk with the penems. Mechanisms of injury include transport into the tubular cell, mainly through the antiluminal organic anion secretory carrier, concentrative uptake through a secretory carrier, based on the consistent correlation between transport and toxicity . (II) Molecular mechanisms: (a) production of a highly reactive acylating metabolite by a cytochrome P-450 dependent mixed-function oxidase; it is the only beta-lactam shown to cause significant oxidative injury; very low limited ability to harm the mitochondrial carriers with regard to pyruvate and the short-chain fatty anions.