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02-7-25 by ripal121 ripal121 replaced Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR with Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min. via Scanner Search and Replace module. | current revision | |
02-7-25 by ripal121 ripal121 replaced Intermittent HD with Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min. via Scanner Search and Replace module. | ||
02-7-25 by conan.macdougal... [email protected] replaced For detailed view of dialysis dosing and evidence, see <a href="https://idmp.ucsfsitebuilder.acsitefactory.com/content/ucsf-adult-antimicrobial-dosing-dialysis-reference-document">Dosing in Hemodialysis</a> document.</p> with via Scanner Search and Replace module. | ||
11-25-24 by ripal121 | ||
11-25-24 by ripal121 | ||
04-24-24 by ripal121 | ||
10-5-23 by kaipe | ||
10-5-23 by kaipe | ||
08-2-21 by [email protected] | ||
07-23-21 by conan.macdougal... | ||
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06-29-21 by [email protected] | ||
10-24-20 by conan.macdougal... | ||
10-16-20 by [email protected] | ||
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07-7-20 by [email protected] | ||
04-20-20 by ucsf_admin | ||
04-20-20 by ucsf_admin | ||
04-20-20 by ucsf_admin |
Dosing: Adult Antimicrobial Dosing, Non-dialysis
Indication | CrCl > 50 mL/min | CrCl 10 - 50 mL/min | CrCl < 10 mL/min |
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Oropharyngeal Infection | 100 mg IV/PO q24h | 50% of target dose IV/PO q24h | 25% of target dose IV/PO q24h |
Esophageal Infection | 200 mg IV/PO q24h | 50% of target dose IV/PO q24h | 25% of target dose IV/PO q24h |
Systemic/Severe Infections* |
≤ 80 kg: 400mg IV/PO q24h 81 – 100 kg: 600 mg IV/PO q24h > 100 kg: 800 mg IV/PO q24h |
50% of target dose IV/PO q24h | 25% of target dose IV/PO q24h |
Prophylaxis for Heme-BMT patients | 400 mg PO/IV q24h | 50% of target dose IV/PO q24h | 25% of target dose IV/PO q24h |
*Higher doses may be necessary in some circumstances such as obese patients with severe infections
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
Indication | Intermittent Hemodialysis | Continuous Hemodialysis* |
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Oropharyngeal Infection | 100 mg IV/PO x1 now, then post-HD | 200 mg IV/PO q24h |
Esophageal Infection | 200 mg IV/PO x1 now, then post-HD | 400 mg IV/PO q24h |
Severe Infections |
400 mg IV/PO x1 now, then post-HD
|
800-1200 mg IV/PO per day, divided q12-24h |
Prophylaxis for Heme-BMT patients | 200 mg IV/PO x1 then post-HD | 400 mg IV/PO q 24h |
*Data suggests that fluconazole clearance in patients receiving CVVHD is higher than in patients with normal renal function, necessitating use of higher dosing. These recommendations have not been evaluated for other continuous renal replacement modalities (ex. CVVH) and may not apply.