Dosing Weights
Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | CrCl > 30 mL/min | 15-30 mL/min | < 15 mL/min |
|---|---|---|---|
| Skin & soft tissue infection, urinary tract infection | 1 DS tablet PO q12h | 1 DS tablet PO daily | 1 SS tablet PO daily |
| Bone and joint infections | 8 mg TMP/kg/day divided q8-12h | 4 mg TMP/kg/day divided q12-24h | 2 mg TMP/kg q24h |
| Systemic GNR infections including GNR Bloodstream Infection, Nocardia, Stenotrophomonas maltophilia* | 10 mg TMP/kg/day divided q8-12h | 5 mg TMP/kg/day divided q12-24h | 2.5 mg TMP/kg q24h |
| Pneumocystis pneumonia, CNS infections | 15 mg TMP/kg/day divided q8 – 12h | 7.5 mg TMP/kg/day divided q12-24h | 5 mg TMP/kg q24h |
| Prophylaxis for Pneumocystis pneumonia (HIV/AIDS) | 1 DS tablet PO daily | 1 SS tablet PO daily | 1 SS tablet PO thrice weekly |
| Prophylaxis for Pneumocystis pneumonia (Heme-BMT) | 1 DS tablet PO thrice weekly | 1 SS tablet PO thrice weekly | |
| Prophylaxis for Pneumocystis pneumonia (SOT)^ | 1 DS tablet PO thrice weekly | ||
*Certain clinical situations may require double coverage. If this is being considered, please contact adult ID or adult ASP.
^Kidney transplant recipients are to follow the KTU protocol, which includes an initial period of daily UTI prophylaxis before transitioning to standard, thrice-weekly PJP prophylaxis.
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
| Indication | Intermittent Hemodialysis | Continuous Hemodialysis |
|---|---|---|
| Skin & soft tissue infection, urinary tract infection | 1 SS tablet PO x1 now then qPM | 1 DS tablet PO q12h |
| Bone and joint infections | 2 mg TMP/kg x1 now and qPM | 8 mg TMP/kg/day divided q8-12h |
| Systemic GNR Infections including GNR Bloodstream Infection, Nocardia, Stenotrophomonas maltophilia* | 2.5 mg TMP/kg x1 now and qPM | 10 mg TMP/kg/day divided q8-12h |
| Pneumocystis pneumonia, CNS infections | 5 TMP/kg IV x1 now and qPM | 15 mg TMP/kg/day IV divided q8h - q12h |
| Prophylaxis for Pneumocystis pneumonia (HIV/AIDS) | 1 SS tablet PO qPM | 1 DS tablet PO daily |
| Prophylaxis for Pneumocystis pneumonia (Heme-BMT) | 1 SS tablet PO thrice weekly | 1 DS tablet PO thrice weekly |
| Prophylaxis for Pneumocystis pneumonia (SOT)^ | 1 DS tablet PO thrice weekly | |
*Certain clinical situations may require double coverage. If this is being considered, please contact adult ID or adult ASP.
^Kidney transplant recipients are to follow the KTU protocol, which includes an initial period of daily UTI prophylaxis before transitioning to standard, thrice-weekly PJP prophylaxis.
Dialysis Notes
Single-strength (SS) tablet contains 80 mg trimethoprim (TMP)
Double-strength (DS) tablet contains 160 mg trimethoprim (TMP)
*May consider Total BW for serious infections