Polymicrobial therapy induced nephrotoxicity: more is not always better

Polymicrobial induced nephrotoxicity (PIN) occurs more commonly in critically ill patients. Exposure to drugs often results in toxicity in kidney which represents a major control system maintaining homeostasis of body and thus is especially susceptible to xenobiotics. We present here an adverse drug reaction which is additive nephrotoxicity with combined antimicrobial use in critically ill patient. Blood urea and serum creatinine levels were raised much above the baseline after a fortnight of therapy. The suspected drugs were withdrawn leading to a gradual improvement and normalization of blood urea and serum creatinine levels This suggested a causal relationship which was possibly due to the administration of nephrotoxic antimicrobials. The present case highlights that critically ill patients on prolonged Polymicrobial therapy should be closely monitored, and dose increments should be made cautiously.