Doripenem Dosing Recommendations for Critically Ill Patients Receiving Continuous Renal Replacement Therapy

Table 4

Dosing recommendations for patients on CRRT [25].

CRRT procedure	Estimated CrCL	Dose	Frequency	Infusion time^a,b	Target attainment (MIC)
CVVH	≤30 mL/min	250 mg	q12h	4 hours	≤1 mg/L
CVVHDF	<5 mL/min	250 mg	q12h	4 hours	≤1 mg/L
CVVHDF	5–30 mL/min	500 mg	q12h	4 hours	≤1 mg/L

aFor patients with acute kidney impairment on CRRT, an infusion time of 4 hours is required, taking into consideration the possible increases in nonrenal clearance of carbapenems in patients with acute renal insufficiency.
bPatients with chronic kidney disease on CRRT can be treated with either a 1- or 4-hour infusion time. Based mainly on pharmacokinetic/pharmacodynamic considerations, a 4-hour infusion time may be more suitable to maximize the percentage time during the dosing interval that the free plasma concentration of doripenem exceeds the minimum inhibitory concentration (% fT > MIC).