Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies

Table 2

Antimicrobial dose recommendations for a theoretical 70 kg patient receiving CRRT at an effluent rate of 33.3 mL/min. Doses recommended in Aronoff et al. guidelines and calculated with the Bugge [4], Kroh [5], and Reetze-Bonorden [6] equations utilizing CKD5, AKI, or normal patient data are shown below. Normal text indicates a dose ≥30% less than the Aronoff dose, bold text indicates a dose ±30% of the Aronoff dose, and italicized text indicates a dose ≥30% greater than the Aronoff dose. The number of doses below, within, or above this range is reported in the final row. An asterisk () denotes insufficient published pharmacokinetic data to allow dose calculation.

Drug name	Aronoff (mg/day)	Bugge (mg/day)			Kroh (mg/day)			Reetze-Bonorden (mg/day)
		CKD5	AKI	Normal	CKD5	AKI	Normal	CKD5	AKI
Acyclovir	525	314	319	399	121	129	249	686	656
Amikacin	525	365		392	348		389	1,605
Amoxicillin	500	681		730	454		527	833
Amphotericin B	350	138	269	317	36	232	304	390	356
Ampicillin	8,000	3,348		3,790	1,832		2,495	3,574
Aztreonam	2,000	3,213		3,458	3,183		3,550	3,495
Cefazolin	4,000	1,152		1,077	613		500	1,333
Cefepime	4,000	2,295	2,765	2,332	1,778	2,483	1,833	1,998	1,080
Cefotaxime	2,000	2,399		2,977	1,501		2,367	2,046
Cefotetan	2,000	1,533		1,279	1,200		820	1,500
Cefoxitin	6,000	1,739		2,358	362		1,290	3,258
Ceftaroline	800			605			508
Ceftazidime	4,000	1,490	1,991	1,680	1,176	1,927	1,461	1,243	488
Ceftriaxone	2,000	826	1,102	1,131	635	1,049	1,093	1,947	1,742
Cefuroxime	2,000	1,696	1,645	1,827	1,377	1,300	1,573	3,481	4,439
Ciprofloxacin	400	608		697	358		492	459
Clindamycin	1,800			2,002			1,932
Daptomycin	280	222	261	234	318	376	335	539	434
Doripenem	750	613	675	835	302	395	635	889	751
Ertapenem	1,000		762	691		877	770		681
Fluconazole	400		244	213		797	750		480
Foscavir	2,100	2,595		2,437	1,950		1,713
Ganciclovir	88	103	108	136	39	47	88	171	71
Gentamicin	120	105	113	105	126	138	126	196	141
Imipenem	2,000	1,175	1,370	1,548	685	977	1,245	881	718
Levofloxacin	250	367	412	437	276	343	381	393	354
Linezolid	1,200	919	817	855	1,006	853	910	1,549	1,634
Meropenem	3,000	1,198	1,645	1,483	642	1,312	1,069	3,222	2,031
Moxifloxacin	400	336	476	342	358	568	368	472	443
Nafcillin	6,000			4,799			4,232
Oseltamivir	150		60	50		23	9		47
Piperacillin	12,000	8,112	7,891	8,743	6,211	5,879	7,156	11,902	12,240
Rifampin	600			479			438
Sulbactam	1,000	1,855		1,887	1,142		1,190	1,456
Tazobactam	1,500		894	933		641	699		1,877
Telavancin	500	495		383	840		672	750
Tigecycline	100	87		89	82		86	102
Tobramycin	120	99	127	90	142	185	129	368	115
Trimethoprim	700			602			574
Vancomycin	1,000	786	1,184	896	623	1,220	788	434	196
Below/within/above ±30% range		12/14/5	12/9/1	12/21/7	17/12/2	13/4/5	14/22/4	7/11/12	7/11/4