Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | CrCl > 50 mL/min | CrCl 10 – 50 mL/min | CrCl < 10 mL/min |
|---|---|---|---|
| Neurosyphilis, meningitis, necrotizing SSTI, toxic shock syndrome | 4 million units IV q4h | 3 million units IV q4h | 3 million units IV q6h |
| Endovascular, bacteremia | 3 million units IV q4h | 3 million units IV q6h | 2 million units IV q6h |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
|
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis |
|---|---|---|
|
Neurosyphilis, meningitis, necrotizing SSTI, toxic shock syndrome |
4 million units IV x1, then 2 million units IV q4h* | 3 million units IV q4h |
| Endovascular, bacteremia | 3 million units IV x1, then 2 million units IV q6h | 3 million units IV q6h |
*Penicillin G Potassium may contain clinically significant amounts of potassium; consider penicillin G sodium instead, if available.
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 Hemodialysis document.