Antimicrobial dosages for adults with impaired kidney function: O

This table gives dosing recommendations for adults with impaired kidney function. For antimicrobial dosing in children with impaired kidney function, seek expert advice.

Table 1. Antimicrobial dosages for adults with impaired kidney function: O
[NB1]
oseltamivir
consider zanamivirKarie 2006
Dosage adjustment based on GFR [NB2]
more than 60 mL/min	normal
30 to 60 mL/min	treatment: 75 mg initial dose then 30 mg 12-hourlyJones 2021 prophylaxis: 30 mg 24-hourly
10 to 30 mL/min	treatment: 30 mg 24-hourly [NB4] prophylaxis: 30 mg 48-hourly
less than 10 mL/min	no data; if essential: treatment: 30 mg 48-hourly prophylaxis: 30 mg every 5 to 7 days
Dosages for dialysis [NB2]
intermittent haemodialysis	treatment: 30 mg at the onset of symptoms, then 30 mg after each dialysis sessionKamal 2015 prophylaxis: 30 mg after dialysis, then 30 mg after alternate dialysis sessions
peritoneal dialysis	treatment: 75 mg at the onset of symptoms, then repeat dose after 5 days prophylaxis: 30 mg after dialysis, then 30 mg every 7 daysPatel 2015
continuous renal replacement therapy	normalLi 2020
Note: GFR = glomerular filtration rate NB1: Dosing in patients with kidney impairment is complex. This table is intended as a guide only, see General considerations for antimicrobial dosage modification in kidney impairment. If relevant, see Dialysis and continuous renal replacement therapy for further guidance on using this table. NB2: ‘Normal’ indicates that the standard dosage regimen for the specific indication in these guidelines should be used. NB3: For multiple-daily doses, percentage dosage adjustments are calculated using the intermittent dose rather than the total daily dose (eg if standard dosing for drug X is 500 mg 6-hourly, then 50% at normal dosing interval = 250 mg 6-hourly, and 100% 12-hourly = 500 mg 12-hourly). NB4: In patients at increased risk of influenza-related complications, an initial dose of 75 mg may be given if 30 mg capsules are not immediately available (and it is not practical to compound a suspension from 75 mg capsules) to ensure timely initiation of oseltamivir therapy.