Table 1 Recommended dosing regimens of the most frequently used renally excreted antimicrobials according to renal function

Piperacillin/tazobatam

16/2 g q24 h CI [56, 57] or 3.375 q6 h EI over 4 hours [51]

4/0.5 g q6 h

3/0.375 g q6 h

2/0.25 g q6 h

Cefotaxime

4 to 6 g q24 h CI [14] or 2 g q4–6 h

2 g q6–8 h

2 g q6–8 h

1 g q6–8 h

Ceftazidime

4 to 6 g q24 h CI [55, 70]

2 g q8 h

1 g q8–12 h

0.5 to 1 g q24 h

Cefepime

4 to 6 g q24 h CI [71] or 2 g q8 h EI over 3 hours [72]

2 g q8 h

2 g q12 h

1 g q24 h

Imipenem

500 mg q4 h [46] or 250 mg q3 h over 3 hours CI [73]

500 mg q6 h

250 mg q6 h

250 mg q12 h

Meropenem

1 g q6 h over 6 hours CI [54]

500 mg q6 h

250 mg q6 h

250 mg q12 h

Ertapenem

ND

1 g q24 h

1 g q24 h

500 mg q24 h

Gentamycin

9 to 10 mg/kg q24 h^b [74]

7 mg/kg q24 h^b [74, 75]

7 mg/kg q36–48 h^b

7 mg/kg q48–96 h^b

Tobramycin

9 to 10 mg/kg q24 h^b [74]

7 mg/kg q24 h^b [74, 75]

7 mg/kg q36–48 h^b

7 mg/kg q48–96 h^b

Amikacin

20 mg/kg q24 h^b [8, 76]

15 mg/kg q24 h^b

15 mg/kg q36–48 h^b

15 mg/kg q48–96 h^b

Ciprofloxacin

600 mg q12 h or 400 mg q8 h [77–79]

400 mg q12 h

400 mg q12 h

400 mg q24 h

Levofloxacin

500 mg q12 h [80]

750 mg q24 h [37]

500 mg q24 h

500 mg q48 h

Vancomycin

30 mg/kg q24 h CI^b [58, 61]

500 mg q6 h^b

500 mg q12 h^b

500 mg q24–72 h^b

Teicoplanin

LD 12 mg/kg q12 h for 3 to 4 doses; MD 6 mg/kg q12 h [81, 82]^b

LD 12 mg/kg q12 h for 3 to 4 doses; MD 4 to 6 mg/kg q12 h [81, 83]^b

LD 12 mg/kg q12 h for 3 to 4 doses; MD 2 to 4 mg/kg q12 h [81, 83]^b

LD 12 mg/kg q12 h for 3 to 4 doses; MD 2 to 4 mg/kg q24 h [81, 83]^b

Daptomycin

ND

6 mg/kg q24 h

6 mg/kg q24 h

6 mg/kg q48 h