Page 288 - HPP ANTIMICROBIAL GUIDELINE 2018

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

Fluoroquinolone

Ciprofloxacin 500-750mg PO 100% 50-75% 50% 250mg PO or
(or 400mg IV) q12h 200mg IV q12h

Levofloxacin 250mg-750mg q24h 100% 250-750mg 250-500mg q48h Dose for CrCl <10
q24-48h

Ofloxacin 200-400mg q12h 100% 100% q24h 50% q24h 100-200mg AD

Macrolide

Clarithromycin 250-500mg q12h 100% <30ml/min: 50% No data. Dose AD

Miscellaneous

Colistin Please refer Guide to Antimicrobial Therapy in the Adult ICU for dosage recommendation

Nitrofurantoin 50-100mg q6h Avoid < 60 Avoid Avoid Not applicable

Trimethoprim/sulfamethoxazole 5mg/kg TMP q8h-q6h 100% 100%q12h Avoid or 2.5-5mg/kg Dose AD Higher doses
TMP q24h in PJP

HPP AMG Antibiotic Dosage In Patients With Impaired Renal Function 139