Piperacillin-Tazobactam - Renal Dosing

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.

eGFR 0 - 20

2.25g IV q8h

Use q6h dosing for HAP or VAP

eGFR 20 - 40

2.25 g IV q6h

Use 3.375g IV q6h dosing for HAP or VAP

eGFR > 40

3.375 - 4.5 g IV q6h

2.25g IV q8h, plus supplemental dose of 0.75g IV after dialysis

Pertioneal Dialysis

2.25 g every 12 hours

Use 2.25 g every 8 hours for HAP or VAP

3.375g IV q6h

Depends on type of renal replacement therapy used

Pharmacist consult recommended