Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | CrCl > 50 mL/min | 41-50 mL/min | 31-40 mL/min | 21-30 mL/min | 11-20 mL/min |
|---|---|---|---|---|---|
| Loading dose | 6 g IV x 1 | 6 g IV x 1 | 6 g IV x 1 | 6 g IV x 1 | 6 g IV x 1 |
| All indications | 6 g IV q8h | 4 g IV q8h | 3 g IV q8h | 5 g IV q24h | 3 g IV q24h |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
| Indication | Intermittent Hemodialysis | Continuous Hemodialysis |
|---|---|---|
| Loading dose | 4 g IV x 1 | N/A |
| All indications | 4 g IV post-HD only | 8 g IV q12h |
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.
Oral fosfomycin is NOT an appropriate stepdown option for most patients on IV fosfomycin for invasive infections. Contact ID/ASP Pharmacy with questions.
Restricted to ID or Antimicrobial Stewardship