Piperacillin 4 gm/Tazobactam 0.5 gm
Normal Dose
(Full dose)
4.5 gm q 6 h (over 30 min)
Conditions | Dose |
|---|---|
CrCl > 40 ml/min | 3.375 gm IV Q6H |
CrCl 20-40 ml/min | 2.25 gm IV Q6H |
CrCl < 20 ml/min | 2.25 gm IV Q6H |
Hemodialysis | 2.25 gm IV Q12H () |
(+0.75 gm AD on dialysis days) | |
CAPD | 2.25 gm q12h |
CRRT | 3.375 g IV q6h over 30 minutes |
SLED | 4.5 g IV q8h (may use extended infusion) |
Conditions | Dose |
|---|---|
CrCl > 40 ml/min | 4.5 gm IV Q6H |
CrCl 20-40 ml/min | 3.375 mg IV Q6H |
CrCl < 20 ml/min | 2.25 gm IV Q6H |
Hemodialysis | 3.375 gm IV Q12H over 6 h |
alt: 2.25 mg IV Q8H | |
CAPD | 2.25 gm IV q8h |
CRRT | 3.375 g IV q6h over 30 minutes |
SLED | 4.5 g IV q8h (may use extended infusion) |
Conditions | Dose |
|---|---|
CrCl > 20 ml/min | 3.375-4.5 gm IV q8h over 4 h |
CrCl < 20 ml/min | 3.375 gm IV Q12H over 4 h |
Hemodialysis | 4.5 gm IV q 12 over 4 h |
CAPD | No data |
CRRT | 3.375-4.5 gm IV q8h over 4 h |
SLED | 4.5 gm IV q8h over 4 h |
In selected cases: Higher piperacillin/tazobactam dosing may be warranted, e.g., sepsis, critically ill, patients with severe infection, infection with MIC > 16 mg/L, obesity with weight > 120 kg or BMI> 40, CrCl > 120, consider extended infusion dosing. (infuse over 4 h)
The Cockcroft-Gault equation may yield inaccurate estimates based on a patient's body weight and BMI. By including additional height information, we can calculate BMI and provide a modified estimate and range.
- Underweight: For a BMI of 18.5 or lower, use the actual body weight for calculations.
- Normal Weight: Use the ideal body weight for calculations.
- Overweight/Obese: For a BMI of 30 or higher, use the adjusted body weight for calculations.
Calculation Steps
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