Intraperitoneal Antibiotic Dosing Recommendations Studied in CAPD Patients6
| INTERMITTENT
per exchange, once daily |
CONTINUOUS
mg per liter, all exchanges |
|
|---|---|---|
| Aminoglycosides | ||
| Amikacin | 2 mg/kg | LD 25, MD 12 |
| Gentamicin | 0.6 mg/kg | LD 8, MD 4 |
| Netilimicin | 0.6 mg/kg daily | MD 10 |
| Cephalosporins | ||
| Cefazolin | 15–20 mg/kg | LD 500, MD 125 |
| Cefepime | 1000 mg | LD 250–500
MD 100–125 |
| Ceftazidime | 1000–1500 mg | LD 500, MD 125 |
| Cefotaxime | 500–1000 mg | ND |
| Ceftriaxone | 1000 mg/ day | ND |
| Penicillins | ||
| Amoxicillin | ND | MD 150 |
| Ampicillin | ND | MD 125 |
| Penicillin G | ND | LD 50,000 u, MD 25,000 u |
| Quinolones | ||
| Ciprofloxacin | ND | MD 50 |
| Ofloxacin | ND | LD 200, MD 25 |
| Others | ||
| Aztreonam | 2 g daily | LD 1000, MD 5008 |
| Clindamycin | ND | MD 300 |
| Daptomycin | ND | LD 100, MD 20 |
| Imipenem/ Cilastatin | 500 mg in alternate exchange | LD 250, MD 50 |
| Meropenem | 1 gm daily | ND |
| Polymyxin B | ND | MD 150,000 u (15 mg) |
| Teicoplanin | 15 mg/kg every 5 days | LD 200 MD 209 |
| Vancomycin | 15–30 mg/kg every 5–7 days* | - |
| Antifungals | ||
| Voriconazole | 2.5 mg/kg daily | NA |
| Combinations | ||
| Ampicillin/ sulbactam | 2 g / 1 g every 12 hours | LD 750 MD 10010 |
| Imipenem/ cilastatin | 500 mg in alternate bags | LD 250, MD 50 |
| Piperacillin/ Tazobactam | ND | LD 4gm/0.5gm
MD 1gm/0.125gm |
| Quinupristin/ dalfopristin | 25 mg/L in alternate bags
(given in conjunction with 500 mg IV BID) |
ND |
Adapted from Table 5. Courtesy of Multimed Inc.
ND = no data
LD = loading dose, in mg
MD = maintenance dose, in mg
kg = kilograms
This dosing applies to anuric patients. For dosing of drugs with renal clearance in patients with residual renal function (defined as >100mL/day urine output), dose should be empirically increased by 25%.7
- * Supplemental doses may be needed for APD pts6
- * On day 5, approximately 25% of CAPD patients will not achieve a peritoneal dialysis effluent (PDE) vancomycin concentration greater than 4 mg/L during daytime exchanges. For APD patients in whom dwell times are even shorter (often less than 2 hours), it is likely that an even higher proportion will have “low” PDE vancomycin concentrations for the duration of nighttime treatment.11