Not On Dialysis: PO Dosing (CrCl)
≥30 mL/min
500-750 mg PO BID
10 to 30 mL/min
500-750 mg PO daily
0 to 10 mL/min
250-500 mg PO daily
Not On Dialysis: IV Dosing (CrCl)
Standard Dose
- CrCl >30 mL/min: 400 mg IV q12h
- CrCl 0 to 30 mL/min: 400 mg IV q24h
High Dose (indicated for coverage for Pseudomonas & bone and joint infections)
- CrCl >30 mL/min: 400 mg IV q8h
- CrCl 0 to 30 mL/min: 400 mg IV q12h
Intermittent Hemodialysis (thrice weekly)
- 500-750 mg PO q24h (give after dialysis on dialysis days)
- 400 mg IV q24h (give dose post HD on HD days)
Peritoneal Dialysis
- 500-750 mg PO q24h
- 400 mg IV q24h
CVVHDF