Antimicrobial dosages for adults with impaired kidney function: P
This table gives dosing recommendations for adults with impaired kidney function. For antimicrobial dosing in children with impaired kidney function, seek expert advice.
|
paromomycin | |
|
Dosage adjustment based on GFR | |
|
more than 50 mL/min |
no data |
|
10 to 50 mL/min |
no data |
|
less than 10 mL/min |
no data |
|
Dosages for dialysis | |
|
intermittent haemodialysis |
no data |
|
peritoneal dialysis |
no data |
|
continuous renal replacement therapy |
no data |
|
peginterferon alfa-2a | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 30 mL/min |
normal |
|
10 to 30 mL/min |
135 micrograms weekly [NB3] |
|
less than 10 mL/min |
135 micrograms weekly [NB3] |
|
Dosages for dialysis | |
|
intermittent haemodialysis |
135 micrograms weekly [NB3] |
|
peritoneal dialysis |
135 micrograms weekly [NB3] |
|
continuous renal replacement therapy |
135 micrograms weekly [NB3] |
|
pentamidine intravenous | |
|
Dosage adjustment based on GFR [NB2] [NB4] | |
|
more than 60 mL/min |
normal |
|
10 to 60 mL/min |
avoid; if essential, normal |
|
less than 10 mL/min |
avoid; if essential, 100% 24- to 36-hourly |
|
Dosages for dialysis [NB4] | |
|
intermittent haemodialysis |
as for GFR less than 10 mL/min; dose after dialysis |
|
peritoneal dialysis |
as for GFR less than 10 mL/min |
|
continuous renal replacement therapy |
avoid; if essential, 100% 24-hourly |
|
peramivirLi 2020 | |
|
Dosage adjustment based on GFR [NB2] | |
|
50 mL/min or more |
normal |
|
30 to 49 mL/min |
200 mg |
|
10 to 29 mL/min |
100 mg |
|
less than 10 mL/min |
avoid; if essential, 100 mg on day one, followed by 15 mg daily |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
100 mg on day one, followed by 100 mg after dialysis |
|
peritoneal dialysis |
no data |
|
continuous renal replacement therapy |
normal |
|
phenoxymethylpenicillin | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
normal |
|
less than 10 mL/min |
normal |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
normal |
|
peritoneal dialysis |
normal |
|
continuous renal replacement therapy |
normal |
|
piperacillin+tazobactam | |
|
Dosage adjustment based on GFR [NB2] [NB4] | |
|
more than 40 mL/min |
normal |
|
20 to 40 mL/min |
100% 8-hourly |
|
less than 20 mL/min |
100% 12-hourly |
|
Dosages for dialysis | |
|
intermittent haemodialysis |
as for GFR less than 20 mL/min |
|
peritoneal dialysis | |
|
continuous renal replacement therapy |
as for GFR 20 to 40 mL/min |
|
posaconazole intravenous | |
|
see product information about accumulation of intravenous solvent | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
not recommended |
|
less than 10 mL/min |
not recommended |
|
Dosages for dialysis | |
|
intermittent haemodialysis |
not recommended |
|
peritoneal dialysis |
not recommended |
|
continuous renal replacement therapy |
not recommended |
|
posaconazole oral | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
normal |
|
less than 10 mL/min |
normal |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
normal |
|
peritoneal dialysis |
normal |
|
continuous renal replacement therapy |
normal |
|
praziquantel | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
normal |
|
less than 10 mL/min |
normal |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
normal |
|
peritoneal dialysis |
normal |
|
continuous renal replacement therapy |
normal |
|
primaquine | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
normal |
|
less than 10 mL/min |
normal |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
normal |
|
peritoneal dialysis |
normal |
|
continuous renal replacement therapy |
normal |
|
procaine benzylpenicillin | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
normal |
|
less than 10 mL/min |
normal |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
normal |
|
peritoneal dialysis |
normal |
|
continuous renal replacement therapy |
no data |
|
pyrantel | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
no data |
|
less than 10 mL/min |
no data |
|
Dosages for dialysis | |
|
intermittent haemodialysis |
no data |
|
peritoneal dialysis |
no data |
|
continuous renal replacement therapy |
no data |
|
pyrazinamide | |
|
Dosage adjustment for daily dose regimen based on GFR [NB2] [NB4] | |
|
more than 30 mL/min |
normal |
|
10 to 30 mL/min |
100% three times per weekAlsultan 2014Launay-Vacher 2005Nahid 2016 |
|
less than 10 mL/min | |
|
Dosages for dialysis [NB2] [NB4] | |
|
intermittent haemodialysis |
100% three times per week on dialysis days only; dose after dialysis |
|
peritoneal dialysis |
100% three times per week |
|
continuous renal replacement therapy |
normal |
|
pyrimethamine | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
10 to 50 mL/min |
normal |
|
less than 10 mL/min |
normal |
|
Dosages for dialysis [NB2] | |
|
intermittent haemodialysis |
normal |
|
peritoneal dialysis |
normal |
|
continuous renal replacement therapy |
normal |
|
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: Close clinical monitoring for adverse reactions is required. Peginterferon alfa-2a dosage adjustment may be required if moderate to severe adverse reactions occur – refer to the peginterferon alfa-2a product information. NB4: 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). | |