More severe infections 16 to 20 mgkgday 8 to 10 mglb. Although no direct relationship of clindamycin to renal damage has been. Renal dosing of antimicrobials gloucestershire hospitals. Cidofovir, cilazapril, cimetidine, ciprofloxacin, cisapride, cisplatin, cladribine, clarithromycin, clemastine, clindamycin, clodronate, clofazamine, clofibrate. Dosing recommendations are based on creatinine clearance calculated using the cockcroftgault equation.
This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. One limitation is that the handbook is a uk publication so some of the drugs and dosing recommendations are not relevant to the australian situation. Perhaps a consideration for future editions might be to include some general comments on the use of. Data sources include ibm watson micromedex updated 4 may 2020, cerner multum updated 4 may 2020. The most current version of the renal dosage adjustment guidelines for antimicrobials and. Tables of antibacterial drug dosages red book 2018 red book. Hemodialysis and peritoneal dialysis are not effective in removing. Marquette general pharmacy dlp renal dosing protocol drug usual dose crcl adjusted mlmin dose hemodialysis peritoneal dialysis comments acyclovir iv 5 20 mgkg q 8h 25 50 100% of dose q12 h manufacturer suggest 1 l of fluid per gram of drug urine output should be maintained at. In it you will find renal doses of numerous antibiotics based on your. The following information includes only the average doses of this medicine.
Clindamycin may be acceptable for use during pregnancy. Clinical course of haemodialysis patients with malignancies and doseadjusted chemotherapy. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. Esrd crcl 90, 6089, 3059, 1529, intravenous piggyback.
What are the most likely bugs based on the infection site. Discontinue therapy permanently and institute appropriate therapy if anaphylactic or severe hypersensitivity reaction occurs. Its major disadvantage is its propensity to cause antibioticassociated diarrhea, including clostridioides formerly clostridium difficile colitis. This book is distributed under the terms of the creative commons. The antibiotic dose for continuous renal replacement therapy d crrt should. As an alternative to vancomycin for mrsa infections, the infectious diseases society of america idsa recommends 600 mg iv every 8 hours for 3 to 4 weeks for septic arthritis and for 4 to 6 weeks for osteomyelitis.
Renal dosage adjustment guidelines for antimicrobials the pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of c. Dosing intervals of every 6 or 8 hours are most commonly used in pediatric practice. Munar, pharmd, bcps, and harleen singh, pharmd oregon state university college of pharmacy, portland, oregon. Clindamycin, sobelin, 3, 3, 900, 600, 68, 600, 68, 600, 68, 600, 600, 68.
A process for assigning all renal patients medication dosing to a pharmacist leaves prescribers more time for other clinical activities and may decrease the risk of adverse drug events. Clindamycin dosage modification may not be necessary in patients with renal disease. Renal dosage adjustment guidelines for antimicrobials. Follow your doctors orders or the directions on the label. In patients with ckd stages 1 through 5 predialysis, the cockcroftgault cg equation see chapter. If your dose is different, do not change it unless your doctor tells you to do so. Cleocin, clindesse clindamycin dosing, indications. Cleocin dosage guidelines for acne treatment, cleocin lotion, gel, or solution are usually applied to the skin once a day. This medication is given by injection into a vein or muscle as directed by your doctor, usually 2 to 4 times a day. Marquette general pharmacy dlp renal dosing protocol.
Should superinfections occur, appropriate measures should be taken as indicated by the clinical situation. The use of cleocin pediatric occasionally results in overgrowth of nonsusceptible organismsparticularly yeasts. Pediatric patients for children who are able to swallow capsules. It can also be used to treat acne, and some cases of methicillinresistant staphylococcus aureus mrsa. For bacterial vaginosis, cleocin cream or suppository products are inserted vaginally once daily before bedtime. Serious infections 8 to 16 mgkgday 4 to 8 mglbday divided into three or four equal doses. Clindamycin 167 clobazam 168 clofazimine 169 clomethiazole chlormethiazole 170. It also saves pharmacists time, since they can adjust doses themselves according to the most current clinical needs without waiting to hear from physicians.
More severe infections 300 to 450 mg every 6 hours. May adjust dose as necessary not to exceed 40 mgkgday. Cleocin clindamycin may treat, side effects, dosage, drug interactions. Cleocin phosphate should not be injected intravenously undiluted as a bolus, but should be infused over at least 1060 minutes as directed in the dosage and administration section. Antibiotic renal dosing list with the age of antibiotic scrutiny upon us and cms starting to put antibiotics under the microscope, remedi seniorcare is happy to provide you with this antibiotic renal dosing list to help you stay compliant. Clindamycin phosphate an overview sciencedirect topics. Every second drug needs dose adjustment to kidney function. Cockcroftgault crcl estimates using the creatinine clearance calculator should be used for drug dosing rather than the automated mdrd egfr produced by the clinical chemistry laboratory available on notis. The level of renal function below which the dose of a drug must be reduced depends largely on the extent of renal metabolism and elimination, and on the drugs toxicity. Cleocin t topical lotion containing clindamycin phosphate equivalent to 10 mg clindamycin per milliliter is available in the following size. Clostridium difficile associated diarrhea cdad has been reported with use of nearly all antibacterial agents, including cleocin hcl and may range in severity from mild diarrhea to fatal colitis. Drug dosing adjustments in patients with chronic kidney disease myrna y.
The information on dosage adjustments in renal impairment given in this book is based on. Use a swab to apply a thin film of clindamycin to affected area q12hr. Clinical judgment about the disease, alterations in renal or hepatic. Refer to renal pharmacist or medicines information for advice on dosing in haemodialysis and peritoneal dialysis. Macrobid nitrofurantoin macrocrystalsnitrofurantoin.
A catalogue record for this book is available from the british library. Dosing guidelines for adults and children, 5th, american college of physicians, 2007. In combination with quinine, it can be used for malaria. Have pharmacists determine all doses for renal patients. Comprehensive update to antimicrobial renal dosing document. Drug dosing adjustments in patients with chronic kidney. Although data are lacking, the fdaapproved labeling states that nitrofurantoin is contraindicated in patients with anuria, oliguria, or severe renal impairment where crcl is less than 60 mlminute and extreme caution is warranted in other patients with renal disease. The dose of this medicine will be different for different patients.
Clindamycin phosphate is administered in the form of an infusion over 1045 minutes, depending on the dose to be administered. In acute on chronic renal impairment the initial dose should correspond to the previous level of chronic renal impairment. Ciprofloxacin, cisatracurium, cisplatin, cladribine, clarithromycin, clindamycin, clonidine, codeine, cyclophosphamide, cyclosporine, cytarabine, dapsone. Clindamycin is an antibiotic used for the treatment of a number of bacterial infections, including bone or joint infections, pelvic inflammatory disease, strep throat, pneumonia, middle ear infections, and endocarditis. The success of nitrofurantoin therapy depends on achieving adequate urinary concentrations of the drug. There is a slightly less than proportional increase for pioglitazone and total pioglitazone at a dose of 60 mg per day. The adjustments listed in the dosing guidelines will be made unless the. When a dosage range is provided, the high dose generally is intended for severe infections. The use of ideal body weight has been shown to be associated with a more predictable muscle strength recovery within 60 minutes and a lack of need for antagonism compared to total body weight. Provides access to the latest drug monographs submitted to the food and drug administration fda. The renal drug handbook the st georges hospital, adult critical. Cleocin pediatric clindamycin palmitate hydrochloride. Antibiotic therapy in patients with renal impairment books overview.
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