Antimicrobial Dosing - Adult - Michigan Medicine

ANTIMICROBIAL DOSING RECOMMENDATIONS FOR ADULT PATIENTS1

Amikacin IV Amoxicillin PO Amoxicillin-clavulanate PO Ampicillin IV Ampicillin-sulbactam IV Azithromycin IV/PO Aztreonam IV

Cefazolin IV Cefepime IV Cefiderocol IV Cefoxitin IV Cefpodoxime PO Ceftaroline IV Ceftazidime IV

Amphotericin B Deoxycholate IV Liposomal Amphotericin B IV Fluconazole IV/PO

Acyclovir IV Acyclovir PO Baloxavir PO Cidofovir IV Foscarnet IV

Antibiotics

Ceftazidime-avibactam IV

Eravacycline IV

Ceftolozane-tazobactam IV

Ertapenem IV

Ceftriaxone IV

Fosfomycin PO

Cefuroxime IV

Gentamicin IV

Cefuroxime PO

Imipenem IV

Cephalexin PO

Imipenem-relebactam IV

Ciprofloxacin IV

Levofloxacin IV/PO

Ciprofloxacin PO

Linezolid IV/PO

Clarithromycin

Meropenem IV

Clindamycin IV

Meropenem-vaborbactam IV

Clindamycin PO

Metronidazole IV/PO

Colistin IV

Minocycline IV/PO

Daptomycin IV

Moxifloxacin IV/PO

Doxycycline IV/PO

Omadacycline PO

Antifungals

Flucytosine PO

Itraconazole PO (Tolsura)

Isavuconazole IV/PO

Micafungin IV

Itraconazole PO

Posaconazole tablet IV/PO

Antivirals

Ganciclovir IV

Oseltamivir PO

Letermovir IV/PO

Remdesivir IV

Maribavir IV

Ribavirin PO

Molnupiravir PO

Ribavirin PO Lung Transplant

Nirmatrelvir-ritonavir PO

Peramivir IV

Footnotes

Omadacycline IV Oxacillin/nafcillin IV Nitrofurantoin capsules PO Nitrofurantoin suspension PO

Penicillin G IV Piperacillin-tazobactam IV

Polymyxin B IV Rifampin IV/PO Tigecycline IV Tobramycin IV Trimethoprim-sulfamethoxazole (TMP-SMX) IV/PO Vancomycin IV

Posaconazole suspension PO Voriconazole IV Voriconazole PO

Valacyclovir PO Valganciclovir PO

Zanamivir INH

ANTIBIOTICS AMIKACIN (IV) AMOXICILLIN (PO)

Cystitis (lower urinary tract infection) Helicobacter pylori infection Pneumonia, other systemic infections AMOXICILLIN-CLAVULANATE (PO) AMPICILLIN (IV) Cystitis (lower urinary tract infection) Systemic infection Endocarditis/CNS infection AMPICILLIN-SULBACTAM (IV) Cystitis (lower urinary tract infection) Systemic infection Acinetobacter infection AZITHROMYCIN (IV/PO) Systemic infection Legionella or Pneumonia in ICU Mycobacterial infection AZTREONAM (IV) All infections, other than infection of CNS CNS infection CEFAZOLIN (IV)

Cystitis (lower urinary tract infection)

Systemic infection

CEFEPIME (IV) Standard dosing for all infections that are not listed below Suspected or proven Pseudomonas infection, pneumonia, febrile neutropenia, CNS infections, septic shock, burn

CEFIDEROCOL (IV) All indications

CEFOXITIN (IV) Systemic infection Mycobacterial infection

CrCl1 >50 mL/min

500 mg q8h 1 g q12h 1 g q8h

875 mg q12h

1 g q6h 2 g q6h 2 g q4h

CrCl1 30-49 mL/min

CrCl1 10-29 mL/min

CrCl1 120 mL/min 2 g q6h

1 g q8h

1 g q12h

500 mg q24h

2 g q8h 1 g q12h

2 g q12h

1 g q24h or 2 g post HD 3x/week

Extended infusion over 4 hours is preferred for most patients

1 g q24h

2 g post HD 3x/week or 500 mg q24h

2 g q12h

1 g q12h

2 g post HD 3x/week or 1 g q24h

CrCl 60-119 mL/min CrCl 30-59 mL/min

2 g q8h

1.5 g q8h

CrCl 15-29 mL/min 1 g q8h

CrCl 50 mL/min 100 mg q12h 400 mg q12h 600 mg q12h 600 mg q8h 2 g q8h

2.5 g (ceftazidime 2 g avibactam 0.5 g) q8h

1.5 g q8h 3 g q8h

750 mg q8h 1.5 g q8h

250 mg q12h 500 mg q12h 500 mg q12h 500 mg q6h or

1 g q8h 400 mg q12h 400 mg q8h

CrCl1 30-49 mL/min 100 mg q12h 400 mg q12h 400 mg q12h 400 mg q8h 2 g q12h

1.25 g (ceftazidime 1 g avibactam 0.25 g) q8h

750 mg q8h 1.5 g q8h

750 mg q8h 1.5 g q8h

250 mg q12h 500 mg q12h 500 mg q12h 500 mg q6h or

1 g q8h 400 mg q12h 400 mg q8h

CrCl1 10-29 mL/min

CrCl1 50 mL/min

CrCl1 30-49 mL/min

CrCl1 10-29 mL/min

CrCl1 50 mL/min 1 g q8h

CrCl1 30-49 mL/min

CrCl1 10-29 mL/min

CrCl1 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download