The majority of antibiotic and antifungal agents used for the treatment of IE require dosing modifications based on renal or hepatic function. However, the most closely monitored is vancomycin and aminoglycosides. This is due in part because (a) therapeutic levels are normally monitored, and (b) the increased likelihood of developing toxicities (i.e., nephrotoxicity) if the level is too high or adverse outcomes (i.e., clinical failure or resistance development) if level is too low. General dosing considerations are included in Table 74-7 for the most commonly used drugs for treating IE. However, specific dosing adjustments for individual patients should be determined by referring to an appropriate drug dosing reference.
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