Table 8.

Antibiotic dosing for patients who are undergoing hemodialysis.

Empirical dosing pending culture results

Vancomycin plus empirical gram-negative rod coverage based on local antibiogram data

OR

Vancomycin plus gentamicin

(Cefazolin may be used in place of vancomycin in units with a low prevalence of methicillin-resistant staphylococci)

Vancomycin: 20-mg/kg loading dose infused during the last hour of the dialysis session, and then 500 mg during the last 30 min of each subsequent dialysis session

Gentamicin (or tobramycin:) 1 mg/kg, not to exceed 100 mg after each dialysis session

Ceftazidime: 1 g iv after each dialysis session

Cefazolin: 20 mg/kg iv after each dialysis session

For Candida infection

An echinocandin (caspofungin 70 mg iv loading dose followed by 50 mg iv daily; intravenous micafungin 100 mg iv daily; or anidulafungin 200 mg iv loading dose, followed by 100 mg iv daily); fluconazole (200 mg orally daily); or amphotericin-B

NOTE. iv, intravenous.