APPENDIX A DOSAGE ADJUSTMENT FOR RENAL IMPAIRMENT Males: isn = 10 = Agel Fels CC iin = 140 ~ Ag Bs Seat mall) ‘Se eeat at) “inoteseptons use ste boy weight. BM < 185 kyu atal BM Rae Append fr BW clin Aarne cela or Cis th CHOP (Chai Keay Disease Eienlgy Clabraive) eqn with th renova of ai utac aes anasto, ‘Adjusted Maintenance Dose for Renal Impairment and Dialysis Loading dose (LD) required prior to Maintenance Dose (MD) ‘Drug Normal Dose oi crcl orci FenalRoplacemont Therapy 30:50 mimin | 10:30 milmin |< 10 milmin Amikacin Fifer AopendixC ‘Aeyelovir HD: Saige 24h IMD : tOrrigiose gh TOmgtkglose gI2h | TOmgigdoseqzth | Smplgldose q2th | CWVH: 1Omghgldose q2ah CCWHDICWHDF: 10mg a2 lAmpicin FO: 25 aah" LO 2g (CW 29 g8h- 12h 29 gth-aBh 2gaeh-qi2h | 2gqi2h-a2an | CWVHD: 2gah "Higher cose range fr CCWHOF: 29 g6h-goh ndcaniis ond meningitis ‘Ampciin/sulboetom HO 9g Lo: 3 ‘CW: 3g gl2he 08h ag gran eqn | CWHD:2y qtr “fer abl fr dosing in MFO (CWHOF: 39 g6h Acierobseterboumsn soon‘Adjusted Maintenance Dose for Renal impairment and Dialysie Loating dose LOI 's required pio to Maintenance Dase MD) agate oa aa oe Fort Ronson TPT S050 minin | 1030mimin |< 10-niin moans eT TT O 12s 12096 raparam | t2pqatn lew tzpatae io 12 Beye oT aaa io saw amy | on 2M ao IMD : 24MU qth = a6h ‘rene aaiiaaet ath - 6h CVVHD: 2MU gah amor i a esos 192 ib sae ca agar 0 2p tana asaia roca tacamn | CHmoyewHO 29 aah 29 ah “fier ae ermenegt AP a emer Seton wae (2 tiv 29012 No 28-9 aie oes rocemn | Comore: 29 teh or 208 estirexine eimaw ass freee eta tseaein cw tapaeh-at2n MO: 159 a8‘Adjusted Maintenance Dose for Renal Impairment and Dialysis acing dose (LD) srequrd prior to Maintenance Dose (MD! ‘Drug Normal Dose orci crc crcl Renal Replacement Therapy 3050 milimin_|_10:30 mimin |< 10 rin Cipratoxacin| FO: zomg @2an LO: 400m9 CCWvH: 200mg 400mg at2n IMD : 400mg @12h- fh Uncranges | 400mg q24h-at2h | 400mg 24h | CWHDYCWWHDF: 400m9 qi2h + Higher dose for ®aerginoss ncten Roa oa Unchanged Tomarkg aah Tomertg aash | NDICWH/CWHDICWHDF: YOmafg ah ovipenem HDi 0am air on Day 1 then 600mG Lo: s00m9 250mg aah 250mg at2hr Nodsta | q24n MD : So0mg ah (CWH: 250m9 gin CCWHDICWHOE: 500mg ah Erepenem HD: 500m th? Wo :19 taqaan 500m9q24h | 500mg q24h | CWHICYWHD/CWWHDF: 19 24h MO: 19924 Ethambuto! HO 620mg GABA 15 20mafkg 24h Uecrenged | TS 20makaatsn | 120makKka a88h | cyyiycWHOICWHOF: 1520maha 24h Fuuconszole HD: 200mg 400% aah? Day 1: 800m CCH adoma a2ah MO = 490mg 00mg q24h* *tignor dose for eran fg) infections CCVVHO)CWHOF: 400-8009 2th‘Adjusted Maintenance Dose for Renal Impairment and Dialysis Loading dose (LD) required prior to Maintenance Dose (MD) Drug / Normal Dose orci crt rch nal Replacement Therapy 30-60 milmin | 10-30 milimin |< 10 mlimin Gentamicin Fifer Appendix C Imspenem HD: 500mg qi, CVVH: 600mg aBh LD: 19 800mg a6h 00mg ah 500mg at2h | CWHDICVVHDF: 500mg a6h MD : 1g a8h Levofioxacin HO: Soom ear LD : 750mg 750mg q48h 500mg aaah 500mg qth | CWE: 2509 2th IMD : 750m9 a2eh WHO: 500mg a2ah CCWHOF: 750m 02h /Meropenem HD: 059 1a a2an LD: 19-29 CCWWHICWHD/ CWHOF: 19-29 a12h Mo ‘ : “ 1.29 12h 800mg 1g @12h | S00me atzh- «2th Osettemivie HD: 7éme a2ant 75mg ath iene aman Noeata | cwHtcwHy CWHOF: 76ma 12h‘Adjusted Maintenance Dose for Renal Impairment and Dialysis “Loading dose (LD) s required prior to Maintenance Dose (MD) Di Wma a ee cic cit oa aco Ty aos0minn | _1020minin |< 10minn Fosaceon era vate asm | asnaem | 22soann [enn 225900 i 45 a vm} 4506 ents ERTTCTROTSTD zessratoteeset | Untaed | asinotactth | ssimgtacam | ™8NOHa “se Rr inp Sioned TO oor rancher" snotocen | srotoatan | s:tmotg azar | ewer: ma azh tt enon ene ah vet Po aad Fare Pert -erataatan | truce trong nO «nn BWV < 40kg: 200mg at2h on Day 7, then 100 mg ai2h