Cefepime - 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 >50 mL/min

2g IV/IM Q8-12h

CrCl 30-50 mL/min

2g IV/IM Q12h

CrCl 10-29 mL/min

1g IV/IM Q24h

CrCl <10 mL/min

500mg IV/IM Q24h

If given after HD

1g IV Q24h

If given with HD

2g IV (Mon/Tues)
2g IV (Wed/Thurs)
3g IV (Fri/Sat)

Load 2g IV/IM, then 2g IV/IM Q12h