Table 2.
Recommended dosing regimens (according to renal function) of the most commonly used renally excreted antimicrobials [[248]]
| |
Renal function |
|||
|---|---|---|---|---|
| Antibiotic | Increased | Normal | Moderately impaired | Severely impaired |
|
Piperacillin/tazobatam |
16/2 g q24 h CI or 3.375 q6 h EI over 4 hours |
4/0.5 g q6 h |
3/0.375 g q6 h |
2/0.25 g q6 h |
|
Imipenem |
500 mg q4 h or 250 mg q3 h over 3 hours CI |
500 mg q6 h |
250 mg q6 h |
250 mg q12 h |
|
Meropenem |
1 g q6 h over 6 hours CI |
500 mg q6 h |
250 mg q6 h |
250 mg q12 h |
|
Ertapenem |
ND |
1 g q24 h |
1 g q24 h |
500 mg q24 h |
|
Gentamycin |
9 to 10 mg/kg q24 hb |
7 mg/kg q24 h |
7 mg/kg q36–48 h |
7 mg/kg q48–96 h |
|
Amikacin |
20 mg/kg q24 h |
15 mg/kg q24 h |
15 mg/kg q36–48 hb |
15 mg/kg q48–96 h |
|
Ciprofloxacin |
600 mg q12 h or 400 mg q8 h |
400 mg q12 h |
400 mg q12 h |
400 mg q24 h |
|
Levofloxacin |
500 mg q12 h |
750 mg q24 h |
500 mg q24 h |
500 mg q48 h |
|
Vancomycin |
30 mg/kg q24 h CI |
500 mg q6 h |
500 mg q12 h |
500 mg q24–72 h |
|
Teicoplanin |
LD 12 mg/kg q12 h for 3 to 4 doses; MD 6 mg/kg q12 h |
LD 12 mg/kg q12 h for 3 to 4 doses; MD 4 to 6 mg/kg q12 h |
LD 12 mg/kg q12 h for 3 to 4 doses; MD 2 to 4 mg/kg q12 h |
LD 12 mg/kg q12 h for 3 to 4 doses; MD 2 to 4 mg/kg q24 h |
| Tigecycline | LD 100 mg; MD 50 mg q12 h | LD 100 mg; MD 50 mg q12 h | LD 100 mg; MD 50 mg q12 h | LD 100 mg; MD 50 mg q12 h |