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Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | Criteria to initiate: CrCl >55 mL/min, SCr<1.5 mg/dL, urine protein <100mg/dL | Increase in SCr of 0.3-0.4 mg/dL | Increase in SCr of >0.5 mg/L or 3+ proteinuria |
|---|---|---|---|
| Systemic Infections: Induction | 5 mg/kg IV once weekly WITH probenecid | 3 mg/kg IV ever week WITH probenecid | Discontinue |
| Systemic Infections: Maintenance | 5 mg/kg IV once every 2 weeks WITH probenecid | 3 mg/kg IV every 2 weeks WITH probenecid | Discontinue |
| BK viruria in kidney or bone marrow transplant patients | 0.25 - 0.5 mg/kg IV once weekly WITHOUT probenecid | ||
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
|
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis |
|---|---|---|
| All Indications | Minimal data; consult ID pharmacy for assistance | |
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.
IV Fluids: Give 1L NS over 1-2 hours prior to cidofovir administration. If able to tolerate, give an additional 1L NS at the start or immediately after cidofovir administration.
Probenecid: 2g PO 3 hours prior to cidofovir, then 1g PO 2 and 8 hours after cidofovir (total 4g)
Unrestricted Indications (select on order entry):
1) Unrestricted use on the hematology/oncology/BMT service
All other use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow