Are Antibiotics Appropriately Dosed in Critically Ill Patients with Augmented Renal Clearance? A Narrative Review
Table 3
Our recommendations for the antibiotic dosing regimen in patients with augmented renal clearance (CrCl 130 ml/min/1.73).
Antibiotics
Dosing regimens
Beta-lactams
Meropenem
2 g every 6–8 hr as a prolonged infusion
Cefepime
Ceftazidime
2 g every 8 hr as a prolonged infusion
Piperacillin-tazobactam
LD: 4 + 0.5 g over 30 min MD: 20 + 2.5 g daily as a prolonged infusion; it seems better to choose other options for treatment of patients with ARC if possible [24, 27]
Glycopeptides
Vancomycin‡
LD: 35 mg/kg MD: 15 mg/kg every 8 hr as a prolonged infusion
Teicoplanin‡
LD: 12 mg/kg (800 mg) every 12 hr for five consequent doses MD: 12 mg/kg mg (800 mg) once daily
Linezolid
800 mg every 12 hr as a continuous infusion
Colistin
LD: 9 mIU MD: 12 mIU/day every 12 hr over 1–2 hr infusion
Aminoglycosides
Gentamycin§
7–10 mg/kg/day every 12 hr
Tobramycin§
Amikacin§
30 mg/kg/day every 12 hr
Fluoroquinolones
Ciprofloxacin
400 mg every 8 hr
Levofloxacin
1000 mg once daily
CrCl: creatinine clearance; LD: loading dose; MD: maintenance dose; ‡based on the total body weight (TBW); §based on the adjusted body weight (ABW = ideal body weight (IBW) + 0.4 (TBW–IBW)).
