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| Revision | Operations | |
|---|---|---|
| 07-20-23 by ripal121 | current revision | |
| 06-13-22 by conan.macdougal... | ||
| 07-26-21 by conan.macdougal... | ||
| 07-23-21 by conan.macdougal... | ||
| 10-16-20 by [email protected] | ||
| 10-16-20 by [email protected] | ||
| 10-16-20 by [email protected] | ||
| 08-12-20 by conan.macdougal... | ||
| 08-12-20 by conan.macdougal... | ||
| 08-12-20 by conan.macdougal... | ||
| 08-12-20 by conan.macdougal... | ||
| 08-12-20 by conan.macdougal... | ||
| 07-10-20 by [email protected] | ||
| 07-7-20 by [email protected] | ||
| 07-7-20 by [email protected] | ||
| 04-20-20 by ucsf_admin | ||
| 04-20-20 by ucsf_admin | ||
| 02-12-20 by [email protected] | ||
| 02-12-20 by [email protected] | ||
| 02-12-20 by [email protected] | ||
Dosing Weights
Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | CrCl > 30 mL/min | < 30 mL/min |
|---|---|---|
| All indications | 8 – 10* mg/kg IV q24h | 8 – 10* mg/kg IV q48h |
*Doses up to 12 mg/kg may be indicated in treatment of some VRE infections - confer with ID/ID pharmacy.
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
|
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis* |
|---|---|---|
| All Indications |
8-10 mg/kg IV x1 now and post-HD Alternate for patients not on stable dialysis schedule: 8-10 mg/kg IV q48h |
6 mg/kg IV q24h** or 8-10 mg/kg IV q48h |
*These recommendations have not been evaluated for patients receiving continuous renal replacement therapy other than CVVHD (ex. CVVH).
**Consider this dose for patients receiving high ultrafiltration rates (ex. CVVHD > 2L/hr) and/or patients with severe infections (ex. endocarditis) and/or receiving combination therapy (ex. with ceftaroline). ID pharmacy guidance is strongly recommended for complex cases and/or use in combination therapy.
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 Renal Replacement Therapy document.
*If Total BW >1.2 times ideal body weight, use adjusted body weight
Not effective in treatment of pneumonia.
Restricted to ID or Antimicrobial Stewardship