Table 3.
Renal Function | Renal Function Estimates | Dose Regimen |
---|---|---|
Augmenteda | CG-CLCR, >120 mL/min | 2 g every 6 hours, 3-hour infusion |
Normal | MDRD-eGFR, 90 to <120 mL/min/1.73 m2 | 2 g every 8 hours, 3-hour infusion |
Mild impairment | MDRD-eGFR, 60 to <90 mL/min/1.73 m2 | 2 g every 8 hours, 3-hour infusion |
Moderate impairment | MDRD-eGFR, 30 to <60 mL/min/1.73 m2 | 1.5 g every 8 hours, 3-hour infusion |
Severe impairment | MDRD-eGFR, 15 to <30 mL/min/1.73 m2 | 1 g every 8 hours, 3-hour infusion |
End-stage renal disease | MDRD-eGFR, <15 mL/min/1.73 m2 | 0.75 g every 12 hours, 3-hour infusion |
Requiring intermittent hemodialysis | 0.75 g every 12 hours, 3-hour infusion, with consideration for supplemental (third) dose of 0.75 g administered after hemodialysis on dialysis days [25] | |
Requiring continuous renal replacement therapy | Dosed based on effluent flow rate | |
≤2 L/hour | 1.5 g every 12 hours | |
2.1 to 3 L/hour | 2 g every 12 hours | |
3.1 to 4 L/hour | 1.5 g every 8 hours | |
≥4.1 L/hour | 2 g every 8 hours |
Abbreviations: CG-CLCR, Cockcroft-Gault creatinine clearance; eGFR, estimated glomerular filtration rate; MDRD, Modification of Diet in Renal Disease.
aPatients with hypermetabolic states due to sepsis [31].