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ABx dosing

antibiotic dosing

QuestionAnswer
Penicillin G 2-5 million units IV q 4-6 h, Dose adjust CrCl <50 ml/min
Penicillin V 250-500 mg po QID, Dose adjust CrCl <50 ml/min
Benzathine penicillin G 600,000-1.2M units IM q 2-4 weeks, Dose adjust CrCl <50 ml/min
Ampicillin 1-2 grams IV q 4-6 hours, 250-500 mg po QID, Dose adjust CrCl <50 ml/min
Amoxicillim 250-500 mg po TID, Dose adjust CrCl <50 ml/min
Nafacillin 1-2 grams IV q 4-6 hours, dose adjust for severe hepatic impairment
Oxacillin 1-2 grams IV q 4-6 hours, dose adjust for severe hepatic impairment
Dicloxacillin 250-500 mg po QID, dose adjust for severe hepatic impairment
Ticarcillin 3 grams IV q 4-6 hours, Dose adjust CrCl <50 ml/min
Indanyl carbenicillin 382-784 mg po QID, Dose adjust CrCl <50 ml/min
Piperacillin 3-4 grams IV q 4-6 hours, Dose adjust CrCl <50 ml/min
Amoxicillin/Clavulanic Acid 500-875 mg po BID, Dose adjust CrCl <50 ml/min
Ampicillin/Sulbactam 1.5-3 grams IV q6h, Dose adjust CrCl <50 ml/min
Ticarcillin/Clavulanic Acid 3.1 grams IV q 4-6 hours, Dose adjust CrCl <50 ml/min
Piperacillin/Tazobactam 3.375 grams IV q 4-6 hours, Dose adjust CrCl <50 ml/min
Cefazolin 1-2 grams IV q 8h, Dose adjust CrCl <50 ml/min
Cefadroxil 500-1000 mg po BID, Dose adjust CrCl <50 ml/min
Cephalexin 250-500 mg po QID, Dose adjust CrCl <50 ml/min
Cefuroxime 250-500 mg po BID, Dose adjust CrCl <50 ml/min
Cefuroxime 750-1000 mg IV Q12h, Dose adjust CrCl <50 ml/min
Cefaclor 250-500 mg po TID, Dose adjust CrCl <50 ml/min
Cefoxitin 1-2 grams IV q6-8h, Dose adjust CrCl <50 ml/min
Cefotetan 1-2 grams IV q12h, Dose adjust CrCl <50 ml/min
Cefmetazole 1-2 grams IV q 8-12 hours, Dose adjust CrCl <50 ml/min
Cefotaxime 1 gram IV q8h
Ceftriaxone 1-2 gram IV q 12-24 hours
Cefixime 400 mg po QD
Cefpodoxime proxetil 200-400 mg po BID
Cefatzidime 1-2 grams IV q 8 hours, Dose adjust CrCl <50 ml/min
Cefoperazone 2-4 grams IV q12h, Dose adjust CrCl <50 ml/min
Cefepime 1-2 grams IV q 8-12 hours, Dose adjust CrCl <50 ml/min
Ceftaroline 1 gram IV q12h, Dose adjust CrCl <50 ml/min
Impenem/Cilastatin 500 mg IV Q6H, Dose adjust CrCl <50 ml/min
Meropenem 500-2000 mg IV q 6-8 hours, Dose adjust CrCl <50 ml/min
Doripenem 500 mg IV q8h, Dose adjust CrCl <50 ml/min
Ertapenem 1000 mg IV q24h, Dose adjust CrCl <50 ml/min
Aztreonam 1-2 grams IV q8h, Dose adjust CrCl <50 ml/min
Gentamicin 1-2 mg/kg q8-12h, 5-7mg/kg q24h, Dose adjust CrCl <60 ml/min per pharmacokinetics
Tobramycin 1-2 mg/kg q8-12h, 5-7mg/kg q24h, Dose adjust CrCl <60 ml/min per pharmacokinetics
Amikacin 7.5 mg/kg q12h, 15-20 mg/kg q24h, Dose adjust CrCl <60 ml/min per pharmacokinetics
Tetracycline 250-500 mg po QID, Dose adjust CrCl <50 ml/min
Doxycyline 100 mg po/IV q12h, hepatically excreted
Erythromycin 250-500 mg po TID/QID, 0.5-1 gram IV q6-8h, Dose adjust for severe Hepatic Dysfunction
Clarithromycin 250-500 mg PO BID, Dose adjust for severe Hepatic Dysfunction
Azithromycin 500 mg IV/po x1 then 250 mg IV/po BID, Dose adjust for severe Hepatic Dysfunction
Clindamycin 300-450 mg po TID/QID, 600-900 mg IV q8h, Dose adjust for severe hepatic dysfunction
Ciprofloxacin 250-750 mg po q8-12h, 200-400 mg IV q8-12h, Dose adjust CrCl <50 ml/min
Levofloxacin 250-750 mg po/IV QD, Dose adjust CrCl <50 ml/min
Gatifloxacin 400 mg po/IV QD, Dose adjust CrCl <50 ml/min
Moxifloxacin 400 mg po/IV QD (Dose adjust CrCl <50 ml/min???- not cleared renally like other flouros)
Gemifloxacin 320 mg po QD, Dose adjust CrCl <50 ml/min
Vancomycin 125-500 mg po q6h, ~15-20 mg,kg IV q12h, Dose adjust CrCl <6ml/min per pharmacokinetics
Metronidazole 250-500 mg po BID-QID, 500 mg IV q6-12h
Linezolid 600 mg po/IV q12h
Quinupristin/Dalfopristin 7.5 mg/kg IV q8-12h
Daptomycin 4-6 mg/kg (actual body weight), Dose adjustment for CrCL <30 ml/min
Tigecycline (Tygacil) 100 mg loading dose followed by 50 mg IV q 12h, no adjustment for renal insufficency
Telavancin 10 mg/kg q 24 h, Dose adjust CrCl <50 ml/min
Fidaxomicin 200 mg po q12h x 10 days
Created by: Kachmiel
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