Ampicillin/Sulbactam - Renal Dosing

In the setting of rapidly improving or worsening renal function, calculations of CrCl are inaccurate. Dosing should be based on estimated renal function instead.

If improving renal function, actual CrCl is likely higher than calculated CrCl.

If worsening renal function, actual CrCl is likely lower than calculated CrCl.

CrCl ≥30 mL/min

1500-3000mg IV Q6h

CrCl 10-29 mL/min

1500-3000mg IV Q12h

CrCl <10 mL/min

1500-3000mg IV Q24h

1500-3000mg IV Q12-24h (doses given on HD days should be given after HD)

Load 3000mg IV, then 1500-3000mg IV Q6-12h