These dosing recommendations are meant as guidance based on available literature and should not replace clinical judgement. Antimicrobial dosing should take into account factors specific to the patient (weight, renal function), antimicrobial (pharmacokinetics, pharmacodynamics, toxicity) and disease-state.
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1 Drugs
TMP/SMX (trimethoprim/sulfamethoxazole)
| Indication | CrCl > 30 mL/min | 15-30 mL/min | < 15 mL/min |
|---|---|---|---|
| Bone and joint infections | 8 mg TMP/kg/day divided Q8-12h | 4 mg TMP/kg/day divided Q12-24h | 2 mg TMP/kg Q24h |
| Systemic GNR infections, Nocardia, Stenotrophomonas maltophilia* | 10 mg TMP/kg/day divided Q8-12h | 5 mg TMP/kg/day divided Q12-24h | 2.5 mg TMP/kg Q24h |
| Pneumocystis pneumonia, CNS infections | 15 mg TMP/kg/day divided Q8 – 12h | 7.5 mg TMP/kg/day divided Q12-24h | 5 mg TMP/kg Q24h |
| Prophylaxis for Pneumocystis pneumonia (Heme-BMT) | 1 DS tablet thrice weekly | 1 SS tablet thrice weekly | |
| Prophylaxis for Pneumocystis pneumonia (SOT) | 1 DS tablet thrice weekly | ||
*Certain clinical situations may require double coverage. If this is being considered, please contact adult ID or adult ASP.
Single-strength (SS) tablet contains 80 mg trimethoprim (TMP)
Double-strength (DS) tablet contains 160 mg trimethoprim (TMP)
*May consider Total BW for serious infections
