Penicillins
| Antimicrobial | Normal Adult Dose | Dose and Interval Adjustment for Renal Impairment | ||
|---|---|---|---|---|
| Creatinine Clearance (mL/min) | ||||
| >50 | 10 - 50 | <10 (Anuric) | ||
| Amoxicillin | 500mg PO q8h | q8h | q8-12h | q12-24h |
| Amoxicillin-clavulanate | 500mg PO q8h | q8h | 10-30mL /min: q12h | q24h |
| 875mg PO q12h | > 30mL/min: NO CHANGE NEEDED | ≤ 30mL/min: Do not use 875mg tab; use 500mg tab (see recommendations above) | ||
| 1000mg-200mg IV q8h |
> 30mL/min: NO CHANGE NEEDED |
10-30mL /min: Initial dose of 1000mg-200mg, then 500mg-100mg q12h |
Initial dose of 1000mg-200mg, then 500mg-100mg q24h | |
| 1000mg-200mg IV q6h |
> 30mL/min: NO CHANGE NEEDED |
≤ 30mL /min: 1000mg-200mg q8h |
||
| Ampicillin | 1-2g IV q4-6h | q4-6h | q6-12h | q12-24h |
| Penicillin VK | 300mg PO q6h | q6h | q8h | q12h |
| Penicillin G Na | 3-4MU IV q4-6h | q6h | q8h | q12h |
| Cloxacillin | 500mg PO q6h | NO CHANGE NEEDED | ||
| 1-2g IV q4-6h | NO CHANGE NEEDED | |||
| Piperacillin-tazobactam | 3.375g IV q6h | 3.375g q6h | 2.25g q6h | 2.25g q8h |
| 4.5g IV q8h | ≥ 20mL/min: NO CHANGE NEEDED | < 20mL/min: 4.5g q12h | ||
| 4.5g IV q6h | q6h | 3.375g q6h | 2.25g q6h | |