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Dosing: Adult Antimicrobial Dosing, Non-dialysis
Indication | > 50 mL/min | 10 – 50 mL/min | < 10 mL/min |
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UCSF: Use SHORT INFUSION only for patients excluded from EXTENDED INFUSION dosing ZSFG: Use SHORT INFUSION unless EXTENDED infusion is recommended by ID |
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Non-Pseudomonas infections |
3.375 g IV q6h |
3.375 g IV q8h |
2.25 g IV q8h |
Documented/Suspected Pseudomonas aeruginosa infection |
CrCl > 20 mL/min: 4.5 g IV q6h |
CrCl < 20 mL/min: 3.375 g IV q8h |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis |
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All Indications | 2.25 g IV q8h |
UCSF: Use EXTENDED infusion: Loading dose of 4.5 g IV over 30 minutes x1, then 4.5 g IV over 4h every 8h (starting 4 hr after loading dose) ZSFG: Contact ID pharmacy |
Dialysis Notes
Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min. For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.
ONLY for patients excluded from EI dosing at UCSF. Exclusion criteria for EI: Resistant or intermediate organism, cystic fibrosis, periprocedural areas, insufficient IV access