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Dosing: Adult Antimicrobial Dosing, Non-dialysis
*Note: These dosing recommendations were updated in 1/2025 to better align with available evidence
| Indication |
CrCl > 50 mL/min |
30 - 49 mL/min |
15 - 29 mL/min |
< 15 mL/min |
|---|---|---|---|---|
| UTI, chorioamnionitis, latency antibiotics for PPROM | 2 g IV q6h | 2 g IV q8h | 2 g IV q12h | 2 g IV q24h |
| Other infections | 2 g IV q4h | 2 g IV q6h | 2 g IV q8h | 2 g IV q12h |
| GBS prophylaxis |
2 g IV x 1 followed by 1 gram IV q4h |
2 g IV x 1 followed by 1 gram IV q6h |
2 g IV x 1 followed by 1 gram IV q6h |
2 g IV x 1 followed by 1 gram IV q8h |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
|
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis |
|---|---|---|
| UTI, chorioamnionitis, latency antibiotics for PPROM | 2 g IV x1 now, then qPM | 2 g IV q8h |
| Other infections | 2 g IV q12h | 2 g IV q6h |
| GBS prophylaxis |
2 g IV x 1 followed by 1 gram IV q12h |
2 g IV x 1 followed by 1 gram IV q6h |
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.