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| Revision | Operations | |
|---|---|---|
| 02-21-25 by kaipe | current revision | |
| 02-21-25 by kaipe | ||
| 02-21-25 by kaipe | ||
| 02-21-25 by kaipe | ||
| 02-21-25 by kaipe | ||
| 02-21-25 by kaipe | ||
| 02-21-25 by kaipe | ||
| 02-21-25 by kaipe | ||
| 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. | ||
| 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. | ||
| 07-31-24 by kaipe | ||
| 07-31-24 by kaipe | ||
| 04-22-24 by kaipe | ||
| 04-22-24 by kaipe 4/22/24: Updated restriction language to match Epic builds | ||
| 07-20-23 by ripal121 | ||
| 02-16-21 by conan.macdougal... | ||
| 08-27-20 by conan.macdougal... | ||
| 08-20-20 by [email protected] | ||
| 08-20-20 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] | ||
| 04-21-20 by ucsf_admin | ||
Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | Dosing | Notes |
|---|---|---|
| All Indications (IV or Delayed-release tablet) | 300 mg IV/PO q12h x 2 doses, then 300 mg IV/PO q24h | No renal dose adjustment (avoid IV if possible in patients with CrCl <50 mL/min due to accumulation of IV vehicle) |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
| Indication | Dosing | Notes |
|---|---|---|
| All Indications (IV or Delayed-release tablet) | 300 mg IV/PO q12h x 2 doses, then 300 mg IV/PO q24h | No dose adjustment in hemodialysis |
Dialysis Notes
Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR.
General Considerations
- For assistance with therapeutic drug monitoring (TDM), see Azole TDM Reference Document.
- Posaconazole SOLUTION has more frequent dosing, low bioavailability, and significant food restrictions. Do not substitute SOLUTION for TABLETS or IV without discussion with ID Pharmacy.
- Review medications for potential drug interactions.
IV formulation - Restriced to ID or Antimicrobial Stewardship except:
Inability to tolerate or absorb enteral medications and one of the following:
1) Prophylaxis against fungal infections in patients on the hematology/BMT/lung/heart transplant services with an intolerance of or contraindications to voriconazole
2) Suspected or documented serious fungal infection in the hematology/BMT or lung transplant services
3) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient
PO formulation - Restricted to ID or Antimicrobial Stewardship except:
1) Prophylaxis against fungal infections in patients on the hematology/BMT/lung/heart transplant services with an intolerance of or contraindications to voriconazole
2) Suspected or documented serious fungal infection in the hematology/BMT or lung transplant services
3) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient