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| Revision | Operations | |
|---|---|---|
| 10-23-24 by ripal121 | current revision | |
| 05-8-24 by ripal121 | ||
| 04-24-24 by ripal121 | ||
| 10-24-23 by kaipe | ||
| 10-19-23 by ripal121 | ||
| 08-16-23 by kaipe | ||
| 08-14-23 by ripal121 | ||
| 08-14-23 by ripal121 | ||
| 08-14-23 by ripal121 | ||
| 07-26-21 by conan.macdougal... | ||
| 06-29-21 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... | ||
| 08-12-20 by conan.macdougal... | ||
| 07-10-20 by [email protected] | ||
| 04-22-20 by ucsf_admin | ||
| 04-22-20 by ucsf_admin | ||
Dosing Weights
Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | CrCl > 30 mL/min | 15-30 mL/min | < 15 mL/min |
|---|---|---|---|
| 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, 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 |
*Certain clinical situations may require double coverage. If this is being considered, please contact adult ID or adult ASP.
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
|
Indication |
Intermittent Hemodialysis |
Continuous Hemodialysis |
|---|---|---|
| Bone and joint infections | 2 mg TMP/kg x1 now and qPM | 8 mg TMP/kg/day divided Q 8-12h |
| Systemic GNR Infections, Nocardia, Stenotrophomonas maltophilia | 2.5 mg TMP/kg x1 now and qPM | 10 mg TMP/kg/day divided q 8-12h |
| Pneumocystis pneumonia, CNS infections | 5 TMP/kg IV x1 now and qPM | 15 mg TMP/kg/day IV divided q8h - q12h |
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.
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