Antimicrobial dosages for adults with impaired kidney function: Q
This table gives dosing recommendations for adults with impaired kidney function. For antimicrobial dosing in children with impaired kidney function, seek expert advice.
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quinine bisulfate or quinine sulfate (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 |
|
quinine dihydrochloride (intravenous) | |
|
give a loading dose of 20 mg/kg over 4 hours; start the maintenance dose 4 hours after the loading dose is completed for severe malaria, do not reduce dose or interval in the first 48 hours | |
|
Dosage adjustment based on GFR [NB2] | |
|
more than 50 mL/min |
normal |
|
20 to 50 mL/min |
5 to 10 mg/kg 8-hourly |
|
10 to 19 mL/min |
5 to 10 mg/kg 12-hourly |
|
less than 10 mL/min |
5 to 10 mg/kg 24-hourly |
|
Dosages for dialysis | |
|
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 |
as for GFR 10 to 20 mL/min |
|
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). | |