Amoxicillin/Clavulanate - 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

500mg PO Q8h or 875mg PO Q12h

CrCl 10-29 mL/min

250-500mg PO Q12h

CrCl <10 mL/min

250-500mg PO Q24h

250-500mg Q24h (doses given on HD days should be given after HD), do not use 875mg or ER tablet