Page 290 - HPP ANTIMICROBIAL GUIDELINE 2018
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ADJUSTMENT FOR RENAL FAILURE Estimated creatinine clearance
Actual Body
ANTIBACTERIAL (CrCl), ml/min COMMENTS
Weight
>90 50-90 15-49 <15
Vancomycin <60kg 750mg q8h 750mg q12h 750mg q24h 750mg *Initial dose, subsequently
based on TDM level
60-80kg 1000mg q8h 1000mg q12h 1000mg q24h 1000mg Alternative: Loading dose
15-20mg/kg, then dose
adjusted based on TDM
81-100kg 1250mg q8h 1250mg q12h 1250mg q24h 1250mg level (not to exceed
2g/dose)
>100kg 1500mg q8h 1500mg q12h 1500mg q24h 1500mg
HPP AMG Antibiotic Dosage In Patients With Impaired Renal Function 140
