Antibiotic | Proposed optimal PD target versus susceptible pathogens | Usual dosage recommendations | Highest dosage recommendations | Critical factors responsible for higher dosages |
---|---|---|---|---|
Meropenem | Cmin > 4 mg/l | 0.5 g q8 h to 0.5 q6 h | 1 g q4–6 h | Very high QUF >2 to 3 l/hour and/or QD >1 to 2 l/hour Significant residual renal function (CLCr >50 ml/minute) Borderline susceptible isolates (MICs of 8 to 16 mg/l) |
Imipenem/cilastatin | Cmin >4 mg/l | 0.5 g q8 h to 0.5 g q6 h | ||
Flucloxacillin | Cmin >4 mg/l | 4 g q8 ha | ||
Piperacillin/tazobactam | Cmin >16 to 64 mg/l | 4.0/0.5 g q8 h | 4.0/0.5 g q4 h | Significant residual renal function (CLCr >50 ml/minute) |
Cefepime | Cmin >8 mg/l | 1 to 2 g q12 h | 2 g q8 h | Very high QUF >2 to 3 l/hour and/or QD >1 to 2 l/hour Residual CLCr >50 ml/minute |
Cefpirome | Cmin >8 mg/l | 1 g q12 h | 2 g q8 h | High non-CRRT related compensatory CL Adsorption to polysulfone haemofilter |
Ceftazidime | Cmin >8 mg/l | 1 g q8 h or 3 g/day CI | 2 to 3 q8 h | Very high CLT (2- to 3-fold higher than in healthy volunteers) |
Ceftriaxone | Cmin >8 mg/l | 2 g q24 h | ||
Teicoplanin | Cmin = 10 to 20 mg/l | LD 6 mg/kg q12 h for 4 doses MD 3 mg/kg q24 h | LD 6 mg/kg q12 h for 4 doses MD 6 mg/kg q24 h | Hypoalbuminaemia Significant residual renal function (CLCr >50 ml/minute) |
Vancomycin | Cmin = 15 to 20 mg/l | 0.25 to 0.5 g q12 h | 0.5 g q6 h | Very high CRRT flow rates (QUF ± QD of 6 l/hour) |
Ciprofloxacin | Cmax/MIC >8 to 10 AUC/MIC >100 | 0.4 g q12 h | ||
Levofloxacin | Cmax/MIC >8 to 10 AUC/MIC >100 | 0.5 g q48 h (or 0.25 q24 h) | 0.5 g q24 h | Very high QUF >3 l/hour |
Moxifloxacin | Cmax/MIC >8 to 10 AUC/MIC >100 | 0.4 g q24 ha | ||
Ofloxacin | Cmax/MIC >8 to 10 AUC/MIC >100 | 0.4 g q8 ha | ||
Linezolid | Cmin >4 mg/l | 0.6 g q12 h | 0.6 g q8 h | Very high CLCRRT High non-CRRT-related CL in some critically ill patients |