Continuous | Intermittent | |||
---|---|---|---|---|
Antibiotic type | No residual renal function | Residual renal function | Initial (loading) dose | Maintenance dose |
Aminoglycosides (IP) | ||||
Gentamicin | 8 mg/L | 4 mg/L | 0.6 mg/kg | 0.75 mg/kg |
Netilmicin | 8 mg/L | 4 mg/L | 0.6 mg/kg | 0.75 mg/kg |
Tobramycin | 8 mg/L | 4 mg/L | 0.6 mg/kg | 0.75 mg/kg |
Amikacin | 25 mg/L | 25 mg/L | 0.6 mg/kg | 0.75 mg/kg |
Cephalosporins (IP) | ||||
Cefazolin | 500 mg/L | 125 mg/L | 20 mg/kg | 500 mg/L |
Cefepime | 500 mg/L | 125 mg/L | 15 mg/kg | 500 mg/L |
Cefotaxime | 500 mg/L | 250 mg/L | 30 mg/kg | 500 mg/L |
Ceftazidime | 500 mg/L | 125 mg/L | 20 mg/kg | 500 mg/L |
Glycopeptides (IP) | ||||
Vancomycin | 1000 mg/L | 25 mg/L | Initial dose: 30 mg/kg Afterward, 15 mg/kg every 3–5 days | |
Teicoplanin | 400 mg/L | 20 mg/L | 15 mg/kg every 5–7 days | |
Penicillin’s (IP) | ||||
Ampicillin | No data | 125 mg/L | No data | |
Quinolones (IP) | ||||
Ciprofloxacin | 50 mg/L | 25 mg/L | No data | |
Others | ||||
Aztreonam (IP) | 1000 mg/L | 250 mg/L | No data | |
Clindamycin (IP) | 300 mg/L | 150 mg/L | No data | |
Imiprem / cilastin (IP) | 250 mg/L | 50 mg/L | No data | |
Linezolid (PO) | < 5 years: 30 mg/kg/day, divided into three doses 5–11 years: 20 mg/kg/day, divided into two doses 12 years≤: 600 mg/session, twice per day | |||
Metronidazole (PO) | 30 mg/kg/day, divided into three doses (maximum of 1200 mg/day) | |||
Rifampin (PO) | 10–20 mg/kg/day, divided into two doses (maximum of 600 mg/day) | |||
Anti-fungals | ||||
Fluconazole (IP, IV, PO) | 6–12 mg/kg/session, every 24–48 h (maximum of 400 mg/day) | |||
Caspofungin (IV) | Initial dose: 70 mg/m2/day (maximum 70 mg/day) Afterwards: 50 mg/m2/day (maximum 50 mg/day) |