Acyclovir

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication

CrCl > 50 mL/min

25 - 50 mL/min

10 - 25 mL/min

< 10 mL/min 

Non-CNS HSV Infections 5 mg/kg IV q8h 5 mg/kg IV q12h 5 mg/kg IV q24h 2.5 mg/kg IV q24h
HSV encephalitis/ Disseminated VZV 10 mg/kg IV q8h 10 mg/kg IV q12h 10 mg/kg IV q24h 5 mg/kg IV q24h

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis
Non-CNS HSV Infections 2.5 mg/kg IV x1 now, then qPM 5 mg/kg IV q24h
HSV encephalitis/ Disseminated VZV 5 mg/kg IV x1 now, then qPM 10 mg/kg IV q12h

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.

Dosing weight as follows:

  • Total body weight (TBW) < IBW: Use TBW
  • Total body weight 1-1.2x IBW: Use IBW
  •  If Total BW > 1.2 times Ideal BW, use Adj BW