5.0 - Antibiotic Doses in Adults With Impaired Renal Function

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5.0 - Antibiotic Doses in Adults With Impaired Renal Function

Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Aminoglycosides
Amikacin IV	15 mg/kg q24H (max 1.5 gm/day)	Normal	7.5 mg/kg q24H	7.5 mg/kg q48 - 72H	7.5 mg/kg q48 - 72H (dose after dialysis) OR add supplemental dose 3.25 mg/kg after dialysis on dialysis day (50% dose dialyzable)	7.5 mg/kg q48 - 72H + 15 - 20 mg lost per litre dialysate per day	7.5 mg/kg q24H
Amikacin IV	15 mg/kg q24H (max 1.5 gm/day)	Multiple Daily Dose > 50 mL/min 7.5 mg/kg q12H 10 - 50 mL/min 7.5 mg/kg q24H < 10 mL/min 7.5 mg/kg q48H					7.5 mg/kg q24H
Gentamicin IV	3 - 5 mg/kg q24H (in septic shock, up to 7 mg/kg q24H) ^¤	Normal ^¤	40 - 59 mL/min: 3 - 5 mg/kg q36H 20 - 39 mL/min: 3 - 5 mg/kg q48H <20 mL/min: 3 - 5 mg/kg single dose and monitor serum levels ^¤	3 - 5 mg/kg single dose and monitor serum levels ^¤	2 - 3 mg/kg loading dose, then 1 - 2 mg/kg q48 - 72H (dose after dialysis) OR Add supplemental dose 0.5 - 1 mg/kg after dialysis on dialysis day (50% dose dialyzable) ^¤	2 - 3 mg/kg loading dose, then 1 - 2 mg/kg q48 - 72H + 8 - 10 mg lost per litre dialysate per day ^¤	2 - 3 mg/kg loading dose, then 1 - 2.5 mg/kg q24 - 48H ^¤
Gentamicin IV	3 - 5 mg/kg q24H (in septic shock, up to 7 mg/kg q24H) ^¤	Multiple Daily Dose > 50 mL/min 1 - 1.7 mg/kg q8H 10 - 50 mL/min 1 - 1.7 mg/kg q12 - 48H < 10 mL/min 1 - 1.7 mg/kg q48 - 72H ^¤					2 - 3 mg/kg loading dose, then 1 - 2.5 mg/kg q24 - 48H ^¤
Streptomycin IV / IM	15 mg/kg (max 1 gm) q24H ^¤	Normal ^¤	15 mg/kg q24 - 72H ^¤	15 mg/kg q72 - 96H ^¤	7.5 mg/kg q48 -72H, dose after dialysis only on dialysis days ^¤	15 mg/kg q72 - 96H + 20 - 40 mg lost per litre dialysate per day^¤	15 mg/kg q24 - 72H ^¤
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Carbapenem
Ertapenem IV	1 gm q24H	Normal	30 - 50 mL/min: 1 gm q24H < 30 mL/min: 0.5 gm q24H	0.5 gm q24H	0.5 gm q24H (if dose < 6 hours prior to HD, add supplemental dose 150 mg after dialysis)	0.5 gm q24H	0.5 - 1 gm q24H
Imipenem / Cilastatin IV	500 mg q6H or 1000 mg q8H	Normal	30 - 59 mL/min: 500 mg q8H < 30 mL/min: 500 mg q12H ^£	500 mg q12H ^£	500 mg q12H, dose after dialysis on dialysis days ^£	500 mg q12H £	500 mg q6 - 8H or 1000 mg q8H ^£
Imipenem / Cilastatin IV	For intermediate sensitivity to Imipenem or CRE combination therapy: 1000 mg q6H ^£	> 90 mL/min: 1000 mg q6H 60 - 90 mL/min: 750 mg q8H ^£	30 - 59 mL/min: 500 mg q6H < 30 mL/min: 500 mg q12H ^£	500 mg q12H ^£	500 mg q12H, dose after dialysis on dialysis days ^£	500 mg q12H ^£	1000 mg q6H £
Meropenem IV	1 gm q8H Meningitis: 2 gm q8H	Normal	26 - 50 mL/min: Usual: 1 gm q12H Meningitis: 2 gm q12H 10 - 25 mL/min: Usual: 500 mg q12H Meningitis: 1 gm q12H	Usual: 500 mg q24H Meningitis: 1 gm q24H	Usual: 500 mg q24H, dose after dialysis on dialysis days Meningitis: 1 gm q24H, dose after dialsysis on dialysis days	Usual: 500 mg q24H Meningitis: 1 gm q24H	Usual: 1 gm q8 - 12H Meningitis: 2 gm q8 - 12H
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Cephalosporin
Cefazolin IV	1 - 2 gm q8H (max 12 gm/day)	Normal	1 - 2 gm q12H	1 - 2 gm q24 - 48H	2 gm q48 - 72H, dose after dialysis only on dialysis days	0.5 gm q12H	Loading dose 2gm ^¤, 1 gm q8H or 2 gm q12H
Cefalexine PO	250 - 1000 mg q6H (max 4 gm/day)	Normal	250 - 1000 mg q12H	125 - 500 mg q12H	250 mg q12 - 24H, dose after dialysis on dialysis days	250 - 1000 mg q12H	Normal ^α
Cefuroxime IV	750 - 1500 mg q6 - 8H	Normal	20 - 50 mL/min: 750 - 1500 mg q8H 10 - 20 mL/min: 750 - 1500 mg q12H ^¤	750 - 1500 mg q24H	750 - 1500 mg q24H, dose after dialysis on dialysis days	750 - 1500 mg q24H	750 - 1500 mg q8 - 12H
Cefuroxime PO	250 - 500 mg q12H	Normal	10 - 29 mL/min: 250 - 500 mg q12H < 10 mL/min: 250 - 500 mg q24H	250 - 500 mg q48H	250 - 500 mg q48H, add supplemental dose 250 - 500 mg after dialysis on dialysis days	250 - 500 mg q24H	No data
Ceftriaxone IV	1 - 2 gm q12 - 24H	Normal	Normal	Normal	Normal No supplemental dose necessary after dialysis	Normal	Normal
Cefotaxime IV	Usual dose 2 gm q8H, up to 1 - 2 gm q4 - 12H	Normal	1 - 2 gm q12 - 24H	1 - 2 gm q24H	1 - 2 gm q24H, dose after dialysis on dialysis days ^¤	0.5 - 1 gm q24H	1 - 2 gm q6 - 8H
Ceftazidime IV	1 - 2 gm q8H	Normal	31 - 50 mL/min: 1 - 2 gm q12H 16 - 30 mL/min: 1 - 2 gm q24H ^¤	0.5 - 1 gm q24 ^¤	1 gm q24H or 2 gm q48 - 72H, dose after dialysis only on dialysis days ^¤	500 mg q24H ^¤	1 - 2 gm q8H ^¤
Cefoperazone IV	1 - 2 gm q12H	Normal	Normal	Normal	Normal No supplemental dose necessary after dialysis	Normal	Normal
Cefepime IV	2 gm q8H (max dose)	Normal	30 - 60 mL/min: 2 gm q12H 11 - 29 mL/min: 2 gm q24H	1 gm q24H	1 gm q24H, add supplemental dose 1 gm after dialysis on dialysis days	1 - 2 gm q48H	2 gm q8 - 12H ^¤
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Fluoroquinolone
Ciprofloxacin IV	200 - 400 mg q12H	Normal	> 30 mL/min: Normal 5 - 29 mL/min: 200 mg q12H or 400 mg q24H ^¤	200 - 400 mg q24H	200 - 400 mg q24H, dose after dialysis on dialysis days	200 - 400 mg q24H	200 - 400 mg q12H
Ciprofloxacin PO	500 - 750 mg q12H	Normal	250 - 500 mg q12H	250 - 500 mg q24H	250 - 500 mg q24H, dose after dialysis on dialysis days	250 - 500 mg q12H	250 - 500 mg q12H
Levofloxacin IV / PO	500 - 750 mg q24H	Normal	Load 500 - 750 mg, then: 20 - 49 mL/min: 250 mg q24H or 750 mg q48H 10 - 19 mL/min: 250 - 500 mg q48H	Load 500 - 750 mg, then 250 - 500 mg q48H	Load 500 - 750 mg, then 250 - 500 mg q48H, dose after dialysis on dialysis days	Load 500 - 750 mg, then 250 - 500 mg q48H	Load 500 - 750 mg, then 250 - 750 mg q24H
Moxifloxacin PO	400 mg q24H	Normal	Normal	Normal	Normal No supplemental dose necessary after dialysis	Normal	Normal
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Macrolide
Azithromycin IV / PO	500 mg q24H	Normal	Normal	Normal	Normal No supplemental dose necessary after dialysis	Normal	Normal
Erythromycin PO	400 - 800 mg q6 - 12H	Normal	Normal	Normal	Normal No supplemental dose necessary after dialysis	Normal	Normal
Clarithromycin PO	250 - 500 mg q12H	Normal	250 - 500 mg q24H	250 - 500 mg q24H	250 - 500 mg q24H, dose after dialysis on dialysis days	250 - 500 mg q24H	250 - 500 mg q12 - 24H
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Penicillin
Amoxicillin PO	Usual dose of 250 - 500 mg q8H, up to 1000 mg q8H	Normal	250 - 500 mg q8 - 12H	250 - 500 mg q24H	250 - 500 mg q24H, dose after dialysis on dialysis days	250 mg q12H	250 - 500 mg q8 - 12H
Co-amoxiclav PO	625 mg q8H	Normal	250 - 500 mg (Amoxicillin component) q12H	250 - 500 mg (Amoxicillin component) q24H	250 - 500 mg (Amoxicillin component) q24H, dose after dialysis on dialysis days	No data	No data
Co-amoxiclav IV	1.2 gm q8H	Normal	30 - 50 mL/min: Normal 10 - 30 mL/min: 1.2 gm q12H ^¥	1.2 gm stat then 600 mg q24H ^£ OR 1.2 gm stat 600 mg q8H OR 1.2 gm q12H ^¥	1.2 gm stat then 600 mg q24H, add supplemental dose 600 mg after dialysis on dialysis days £ OR 1.2 gm q12H	1.2 gm stat then 600 mg q8H or 1.2 gm q12H ^¥	1.2 gm q8 - 12H ^¥
Ampicillin IV	1 - 2 gm q6H, up to 2 gm q4H (max 12 gm/day)	Normal	30 - 50 mL/min: 1 - 2 gm q8H 10 - 30 mL/min: 1 - 2 gm q12H	1 - 2 gm q12H	1 - 2 gm q12H, dose after dialysis	500 - 1000 mg q12H	1 - 2 gm q6 - 8H ^¤
Ampicillin / Sulbactam IV	Usual dose: 1.5 - 3 gm q6 - 8H	Normal	1.5 - 3 gm q8 - 12H	1.5 - 3 gm q12 - 24H	1.5 - 3 gm q12 - 24H, dose after dialysis	1.5 - 3 gm q12 - 24H	1.5 - 3 gm q6 - 8H ^¤
Ampicillin / Sulbactam IV	Multidrug resistant acinetobacter: 3 gm q4H	Normal	3 gm q6H	3 gm q8H	3 gm q8H, dose after dialysis on dialysis days	3 gm q8H	3 gm q4H
Benzylpenicillin IV	1 - 4 MU q4 - 6H ^¤	Normal	75% of dose q4 - 6H ^¤	20 - 50% of dose q4 - 6H ^¤	25 - 50% of dose q4 - 6H, dose after dialysis ^¤	25 - 50% of dose q4 - 6H ^¤	2 - 4 MU q4 - 6H ^¤
Cloxacillin IV / PO	1 - 2 gm q4 - 6H	Normal	Normal	Normal	Normal	Normal	Normal
Piperacillin / Tazobactam IV	4.5 gm q6H	Normal	20 - 40 mL/min: 4.5 gm q8H 10 - 20 mL/min: 2.25 gm q6H	2.25 gm q6H	2.25 gm q8H, add supplemental dose 0.75 gm after dialysis on dialysis days	2.25 gm q8H	4.5 gm q8H
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Tetracycline
Doxycycline PO	100 mg q12H	Normal	Normal	Normal	Normal	Normal	Normal
Minocycline PO	LD 200 mg, 100 mg q12H	Normal	Normal	Normal	Normal	Normal	Normal
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Miscellaneous
Clindamycin IV / PO	600 mg q6 - 8H or 900 mg q8H	Normal	Normal	Normal	Normal	Normal	Normal
Colistin IV Ω Ψ	LD 9 MU, then start maintenance 4.5 MU q12H 24 hours after LD	Normal	20 - 50 mL/min: 4.5 MU q24H < 20 mL/min: 4.5 MU q48H	2.5 MU q24H	2.5 MU q24H, add supplemental dose 0.8 MU after dialysis on dialysis days	No data	4.5 MU q12H
Linezolid IV / PO	600 mg q12H	Normal	Normal	Normal	Normal	Normal	Normal
Metronidazole IV	500 mg q6 - 12H or 7.5 mg/kg q6H (max 4 gm/day)	Normal	Normal	500 mg q8 - 12H or 7.5 mg/kg q12H	500 mg q8 - 12H or 7.5 mg/kg q12H, dose after dialysis	500 mg q8 - 12H or 7.5 mg/kg q12H	500 mg q6 - 12H or 7.5 mg/kg q6H
Polymyxin B IV	Loading Dose: 2.5 mg/kg STAT over 2 hours Maintenance Dose, to start 12 hours after loading dose: 1.5 mg/kg BD, each dose over 1 hour (Obese patient: consider using adjusted body weight)	Normal	Normal	Normal	Normal	Normal	Normal
Trimethoprim / Sulfamethoxazole IV / PO	Treatment: Trimethoprim component 8 - 20 mg/kg/day divided to q6 - 12H	Normal	30 - 50 mL/min: Normal 10 - 29 mL/min: Trimethoprim component 2.5 - 5 mg/kg q12H	Use not recommended, but if required, Trimethoprim component 5 - 10 mg/kg q24H	Use not recommended, but if required, Trimethoprim component 5 - 10 mg/kg q24H	Use not recommended, but if required, Trimethoprim component 5 - 10 mg/kg q24H	Trimethoprim component 5 - 10 mg/kg q12H ^¤
Trimethoprim / Sulfamethoxazole IV / PO	Prophylaxis: 1 - 2 tabs PO q24H	Normal	Normal	Normal	Normal	Normal	Normal
Vancomycin IV	15 - 20 mg/kg q8 - 12H Max 2 gm/dose Max infusion rate: 1 gm/hour Max dilution concentration: 1 gm/100mL	Normal	50 - 90 mL/min: 15 mg/kg q12H 15 - 49 mL/min: 15 mg/kg q24H	< 15 mL/min: 15 - 20 mg/kg single dose Send random TDM sample next morning. If TDM service not available next day, for 7.5 - 10 mg/kg single dose 24 hours after LD, then to monitor TDM levels.	15 - 20 mg/kg single dose Send random TDM sample next morning. If TDM service not available next day, for 7.5 - 10 mg/kg single dose 24 hours after LD, then to monitor TDM levels.	15 - 20 mg/kg single dose Send random TDM sample next morning. If TDM service not available next day, for 7.5 - 10 mg/kg single dose 24 hours after LD, then to monitor TDM levels.	7.5 - 10 mg/kg q12 - 24H
Vancomycin IV		Refer to pharmacy if in doubt
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Antifungal
Amphotericin B IV	0.3 - 1 mg/kg q24H	Normal	Normal	Normal	Normal	Normal	Normal
Fluconazole IV / PO	100 - 400 mg q24H	Normal	50 - 200 mg q24H	50 - 200 mg q24H	100 - 400 mg q48 - 72H, dose after dialysis only on dialysis days OR 50 - 200 mg q24H, dose after dialysis on dilaysis days	50 - 200 mg q24H	200 - 400 mg q24H
Itraconazole PO	100 - 200 mg q12H (max 600 mg/day)	Normal	Normal	No data	No data	100 mg q12 - 24H	100 - 200 mg q12H
Voriconazole IV	6 mg/kg q12H for 2 doses then 4 mg/kg q12H	Normal	Not recommended	Not recommended	No data	No data	No data
Voriconazole PO	> 40 kg: 400 mg q12H for 2 doses, then 200 mg q12H < 40 kg: 200 mg q12H then 100 mg q12H	Normal	Normal	Normal	Normal	Normal	Normal
Caspofungin IV	70 mg on D1, followed by 50 mg q24H	Normal	Normal	Normal	Normal	Normal	Normal
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Antiparasitic
Pentamidine IV	4 mg/kg q24H	Normal	Normal	4 mg/kg q24 - 36H	4 mg/kg q48H, dose after dialysis	4 mg/kg q24 - 36H	4 mg/kg q24H
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Antituberculous
Rifampicin PO	10 mg/kg q24H	Normal	Normal	Normal	Normal	Normal	Normal
Isoniazide PO	5 mg/kg q24H	Normal	Normal	Normal	Normal	Normal	Normal
Ethambutol PO	15 - 25 mg/kg q24H	Normal	30 - 50 mL/min: 15 - 25 mg/kg q24 - 36H 10 - 30 mL/min: 15 - 25 mg/kg q24 - 48H	15 - 25 mg/kg q48H	15 - 25 mg/kg q48H after dialysis	15 - 25 mg/kg q48H	15 - 25 mg/kg q24H
Pyrazinamide PO	20 - 25 mg/kg q24H (max 2.5 gm/day)	Normal	< 30 mL/min: 25 - 35 mg/kg 3x/week ^¤	25 - 35 mg/kg 3x/week ^¤	25 - 35 mg/kg 3x/week after dialysis ¤	20 - 25 mg/kg q24H ^¤	20 - 25 mg/kg q24H ^¤
Antibiotic	Dose for Normal Renal Function	Dosage Adjustment For Renal Failure According to Estimated Creatinine Clearance			Doses For Dialysis
Antibiotic	Dose for Normal Renal Function	> 50 mL/min	10 - 50 mL/min	< 10 mL/min	HD	CAPD	CRRT
Antiviral
Acyclovir IV	5 - 10 mg/kg q8H ^¤	Normal	25 - 50 mL/min: 5 - 10 mg/kg q12H 10 - 25 mL/min: 5 - 10 mg/kg q24H ^¤	2.5 - 5 mg/kg q24H ^¤	2.5 - 5 mg/kg q24H, dose after dialysis ^¤	2.5 - 5 mg/kg q24H ^¤	5 - 10 mg/kg q12 - 24H ^¤
Acyclovir PO	200 - 800 mg q8H or 5 times ^¤	Normal	10 - 25 mL/min: 200 - 800 mg q8H ^¤	200 - 800 mg q12H ^¤	200 - 800 mg q12H, dose after dialysis ¤	200 - 800 mg q12H ¤	No data
Ganciclovir IV	Induction Dose
	5 mg/kg q12H	> 70 mL/min: Normal 50 - 69 mL/min: 2.5 mg/kg q12H	25 - 49 mL/min: 2.5 mg/kg q24H 10 - 24 mL/min: 1.25 mg/kg q24H	1.25 mg/kg 3x/week	1.25 mg/kg 3x/week, dose after dialysis on dialysis days	1.25 mg/kg 3x/week	2.5 mg/kg q12H ^¤
	Maintenance Dose
	5 mg/kg q24H	> 70 mL/min: Normal 50 - 69 mL/min: 2.5 mg/kg q24H	25 - 49 mL/min: 1.25 mg/kg q24H 10 - 24 mL/min: 0.625 mg/kg q24H	0.625 mg/kg 3x/week	0.625 mg/kg 3x/week, dose after dialysis on dialysis days	0.625 mg/kg 3x/week	2.5 mg/kg q24H ^¤
Lamivudine PO	Hepatitis B: 100 mg q24H HIV: 150 mg q12H or 300 mg q24H	Normal	Hepatitis B: 15 - 50 mg q24H HIV: 50 - 150 mg q24H	Hepatitis B: 10 - 15 mg q24H HIV: 25 - 50 mg q24H	Hepatitis B: 10 - 15 mg q24H, dose after dialysis on dialysis days HIV: 25 - 50 mg q24H, dose after dialysis on dialysis days	Hepatitis B: 10 - 15 mg q24H HIV: 25 - 50 mg q24H	100 mg first day, then 50 mg/day
Oseltamivir PO	75 mg q12H	Normal	30 - 60 mL/min: 30 mg q12H 10 - 29 mL/min: 30 mg q24H	No data	30 mg after each dialysis day, no drug on non-dialysis days. Treatment duration not to exceed 5 days. Assumes 3 HD session in 5 days period.	30 mg single dose to provide a 5-day duration	75 mg q12 - 24H
Telbivudine PO	600 mg q24H	Normal	30 - 49 mL/min: 600 mg q48H 10 - 29 mL/min: 600 mg q72H	600 mg q96H	600 mg q96H, dose after dialysis on dialysis days	No data	No data
Tenofovir PO	300 mg q24H	Normal	30 - 49 mL/min: 300 mg q48H 10 - 29 mL/min: 300 mg q72 - 96H	No data	300 mg after every 3^rd dialysis or every 7 days if no dialysis	No data	No data
Tenofovir / Emtricitabine PO	300 / 200 mg (1 tab) q24H ^¤	Normal ^¤	30 - 49 mL/min: 1 tab q48H < 30 mL/min: Not recommended ^¤	Not recommended ^¤	Not recommended ^¤	Not recommended ^¤	Not recommended ^¤
Valacyclovir PO	1 gm q8H	Normal	1 gm q12 - 24H	500 mg q24H	500 mg q24H, dose after dialysis on dialysis days	500 mg q24H	1 gm q12 - 24H
Zidovudine PO	300 mg q12H	Normal	>15 mL/min: 300 mg q12H	< 15 mL/min: 100 mg q8H or 300 mg q24H	100 mg q8H, dose after dialysis on dialysis days	100 mg q8H	300 mg q12H

Reference:

The Sanford Guide to Antimicrobial Therapy 2014

¤ Lexicomp Version 4.1.0, 2017

α Therapeutic Guideline, Antibiotic Version 14, 2010

¥ Renal Handbook

£ Product insert

Ω Garonzik et al. Population Pharmacokinetics of Colistin Methanesulfonate and Formed Colistin in Critically Ill Patients from a Multicenter Study Provide

Dosing Suggestions for Various Categories of Patiens. Antimicrob Agents Chemother 2011 Jul;55(7):3284-94
Ψ Karvanen et al. Colistin Methanesulfonate and Colistin Pharmacokinetics in Critically Ill Patients Receiving COntinous Venovenous Hemodiafiltration.
Antimicrob Agents Chemother 2013; 57(1): 668-671

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5.0 - Antibiotic Doses in Adults With Impaired Renal Function

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