The use of antibiotics in patients with kidney diseases is associated mainly with urinary tract infections (UTI) and urosepsis. Treatment of bacterial infections not related to UTI in patients with chronic renal failure is usually more complicated than in subjects with normal renal function. The high incidence of UTI, recurrent and chronic character of these disorders make them difficult to cure. In all these situations it is important to use effective drugs, without nephrotoxicity, with minimal risk of building up the resistance. Due to the increasing number of dialysis patients, especially treated with hemodialysis, it becomes essential to use effective antibacterial therapy in this group of patients, including infections specific for this kind of treatment. Proper mode of treatment adjusted to type of renal replacement therapy (hemodialysis, peritoneal dialysis or continuous renal replacement therapy) is very important.