Dosing Weights
Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication |
Dose |
Notes |
|---|---|---|
| Cryptococcal meningitis |
4 mg/kg IV q 24h (in combination with flucytosine) |
No adjustment for renal dysfunction; monitor serum creatinine and electrolytes |
| Invasive fungal infections | 5 mg/kg IV q24h | |
| Mold prophylaxis (Heme/BMT) | 3 mg/kg IV q24h |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
|
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis |
|---|---|---|
| Cryptococcal meningitis |
4 mg/kg IV q 24h (in combination with flucytosine) |
4 mg/kg IV q 24h (in combination with flucytosine) |
| Invasive fungal infections | 5 mg/kg IV q24h | 5 mg/kg IV q24h |
| Prophylaxis (heme/BMT) | 3 mg/kg IV q24h | 3 mg/kg IV q24h |
Dialysis Notes
*Use Total Body Weight if Total Body Weight < Ideal Body Weight. If Total Body Weight >1.2 times Ideal Body Weight, use Adjusted Body Weight
IV Fluids: Give 500mL Normal Saline before and after AmBisome administration if able to tolerate
IV formulation - Restricted to ID or Antimicrobial Stewardship except:
1) Documented or suspected serious fungal infection in a patient intolerant of or with contraindications to azoles
2) Prophylaxis against fungal infections in patients on the hematology/BMT service or lung transplant service
3) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient