Page 282 - HPP ANTIMICROBIAL GUIDELINE 2018

Appendix 1 : Antibiotic Dosages In Patients With Impaired Renal Function (Adult)

Unless stated, adjusted doses are % of dose for normal renal function
For critical care patient, kindly refer to Guide to Antimicrobial Therapy in the Adult ICU 2017

CrCl (ml/min)= (140-Age) x BW (kg) x (1.04 for female) or (1.23 for males)
Serum creatinine (micromol/l)

ADJUSTMENT FOR RENAL FAILURE
DOSE FOR NORMAL Estimated creatinine clearance (CrCl), SUPPLEMENT FOR
ANTIBACTERIAL COMMENTS
RENAL FUNCTION ml/min DIALYSIS
> 50 10-50 < 10

Aminoglycoside

Amikacin 7.5mg/kg q12h or 100% 100% 100% Extra 1/2 of normal Dosage adjustment
15mg/kg/day q24-72h q48h-72h renal function dose AD should be based on
by levels by levels TDM level where
possible

Gentamicin 1.7mg/kg q8h or 100% 100% 100% Extra 1/2 of normal
5mg/kg/day q12-48h q48-72h renal function dose AD
by levels by levels

Streptomycin 15mg/kg (max. of 1gm) 100% 100% 100% Extra 1/2 of normal
q24h q24-72h q72-96h renal function dose AD

AD = after dialysis. “Dose AD” refers only to timing of dose with NO extra drug
D = dosage reduction, I = interval extension, SGC=Soft gel capsule, HD – Haemodialysis, PD – Peritoneal dialysis

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