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. 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. 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