Amoxicillin-Clavulanate
Renal

Renal

In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.

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

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

Note

Adjusted dose refers to the amoxicillin component

PO

Not On Dialysis (EGFR)
  • <10 eGFR: 250-500mg daily - BID
    • Do not use 875mg tablet, if eGFR <30
  • 10 - 30 eGFR: 250-500mg PO BID
    • Do not use 875mg tablet, if eGFR <30
  • 30+ eGFR: 875mg PO BID or 500mg PO TID
Intermittent Dialysis

250-500mg PO BID

IV

Not On Dialysis
  • ≥30 eGFR: No dosage adjustment necessary
  • <30 eGFR: 1000mg followed by 500mg every 12 hours
Intermittent Dialysis

1000mg followed by 500mg every 12 hours

Peritoneal Dialysis

1000mg followed by 500mg every 12 hours