Dosing Weights
Dosing: Adult Antimicrobial Dosing, Non-dialysis
Adenovirus*
| High Dose Strategy | 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 |
|---|---|---|---|
| Induction (initial dosing) | 5 mg/kg IV once weekly WITH probenecid x 2 doses | 3 mg/kg IV once weekly WITH probenecid x 2 doses | Discontinue |
| Maintenance | 5 mg/kg IV once every 2 weeks WITH probenecid | 3 mg/kg IV every 2 weeks WITH probenecid | Discontinue |
*There may be alternative dosing available, particularly in renal impairment. Discuss with ID pharmacist to evaluate if patient meets criteria.
At UCSF, there is an adult inpatient order set available for use – IP Adult Cidofovir (VISTIDE) Order set
BK virus*
| High Dose Strategy | 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 |
|---|---|---|---|
| Induction (initial dosing) for BK viruria (hemorrhagic cystitis) in hematopoietic cell transplant recipients | 5 mg/kg IV once weekly WITH probenecid x 2 doses | 3 mg/kg IV once weekly WITH probenecid x 2 doses | Discontinue |
| Maintenance for BK viruria (hemorrhagic cystitis) in hematopoietic cell transplant recipients | 5 mg/kg IV once every 2 weeks WITH probenecid | 3 mg/kg IV every 2 weeks WITH probenecid | Discontinue |
| Low Dose Strategy | 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 |
|---|---|---|---|
|
BK viremia (BK nephropathy) in kidney transplant |
0.25 - 0.5 mg/kg IV once weekly WITHOUT probenecid | 0.25 - 0.5 mg/kg IV once weekly WITHOUT probenecid | Discontinue |
*There may be alternative dosing available, particularly in renal impairment. Discuss with ID pharmacist to evaluate if patient meets criteria.
At UCSF, there is an adult inpatient order set available for use – IP Adult Cidofovir (VISTIDE) Order set
Cytomegalovirus (CMV)
| 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 | |
|---|---|---|---|
| Induction (initial dosing) | 5 mg/kg IV once weekly WITH probenecid x 2 doses | 3 mg/kg IV once weekly WITH probenecid x 2 doses | Discontinue |
| Maintenance | 5 mg/kg IV once every 2 weeks WITH probenecid | 3 mg/kg IV every 2 weeks WITH probenecid | Discontinue |
At UCSF, there is an adult inpatient order set available for use – IP Adult Cidofovir (VISTIDE) Order set
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.
IV Fluids: Give 1L NS over 30 minutes 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)
Restrict to ID or Antimicrobial Stewardship except:
1) For treatment or prophylaxis against viral infection in a BMT patient