Other
| Antimicrobial | Normal Adult Dose | Dose and Interval Adjustment for Renal Impairment | ||
|---|---|---|---|---|
| Creatinine Clearance (mL/min) | ||||
| >50 | 10 - 50 | <10 (Anuric) | ||
| Aztreonam | 1-2g IV q8h | q8h | 50-75% dose | 25% dose |
| Colistin | 5mg colistin base/kg/day IV div q8h | > 70mL/min: NO CHANGE NEEDED | 10-70mL/min: q8-12h | < 10mL/min: q12h |
| Doxycycline | 100mg PO/IV q12-24h | NO CHANGE NEEDED | ||
| Tigecycline | 100mg IV x 1 dose then 50mg IV q12h | NO CHANGE NEEDED | ||
| Clindamycin | 150-450mg PO q6h | NO CHANGE NEEDED | ||
| 600mg IV q8h | NO CHANGE NEEDED | |||
| Metronidazole | 500mg PO/IV q12h | NO CHANGE NEEDED | ||
| Trimethoprim-sulfamethoxazole | 1 DS tab PO q12h | > 25mL/min: NO CHANGE NEEDED | 15-25mL/min: 50% dose | < 15mL/min: DO NOT USE |
| 160-240mg TMP (10-15mL) IV q6, 8, or 12h | > 25mL/min: NO CHANGE NEEDED | 15-25mL/min: 50% dose | < 15mL/min: DO NOT USE | |
| Trimethoprim | 100mg PO q12h | > 30mL/min: NO CHANGE NEEDED | 15-30mL/min: 50mg PO q12h | < 15mL/min: DO NOT USE |
| Fosfomycin | 3g PO once | NO CHANGE NEEDED | ||
| Fosfomycin IV | See adult dosing | NO CHANGE NEEDED |
40mL/min: 70% in 2-3 divided doses
30mL/min: 60% in 2-3 divided doses
20mL/min: 40% in 2-3 divided doses |
10mL/min: 20% in 1-2 divided doses |
| Nitrofurantoin | 50-100mg PO q6h | < 40-60mL/min: CONTRAINDICATED - DO NOT USE | ||
| Nitrofurantoin (MacroBID) | 100mg PO q12h | < 40-60mL/min: CONTRAINDICATED - DO NOT USE | ||
| Vancomycin IV | 15mg/kg IV q12h | q12-24h | q24-48h | use serum levels to assist dosing |
| Vancomycin PO | 125mg PO qid | NO CHANGE NEEDED | ||
| Linezolid | 600mg PO/IV q12h | NO CHANGE NEEDED | ||
| Daptomycin | 4-6mg/kg IV q24h | q24h | < 30mL/min: q48h | |