Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | CrCl >50 mL/min | 31-50 mL/min | 16-30 mL/min | < 15 mL/min |
|---|---|---|---|---|
| Loading Dose* | 2.67 g IV x 1 (over 3 hours) | 2.67 g IV x 1 (over 3 hours) | 1.8 g IV x 1 (over 3 hours) | 1.33 g IV x 1 (over 3 hours) |
| Maintenance Dose: All Indications | 2 g IV every 6 hours (over 3 hours) | 1 g IV every 6 hours (over 3 hours) | 0.9 g IV every 8 hours (over 3 hours) | 0.9 g IV every 12 hours (over 3 hours) |
*Recommended to start maintenance dose beginning at the next dosing interval
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
| Indication | Intermittent Hemodialysis | Continuous Hemodialysis |
|---|---|---|
| Loading Dose* | 1.33 g IV x 1 (over 3 hours) | Insufficient data; discuss with ID/ASP pharmacy |
| Maintenance Dose: All Indications | 0.9 g IV every 12 hours (over 3 hours) |
*Recommended to start maintenance dose beginning at the next dosing interval
Dialysis Notes
Dialysis Notes
Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.
Restricted to ID or Antimicrobial Stewardship