We are in the process of updating our empiric antibiotic recommendations for patients with suspected bacteremia/tunnel infections. We will be including ceftazidime empirically for patients who present with a septic picture. I am curious to know what dosing other sites are using. Most references I have looked at suggest 1g 3x weekly on dialysis but it looks like some sites are using 2g or weight-based dosing. Does anyone have a good reference for this dosing?
I appreciate your input. Thanks! Lindsay
I like this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3837845/
This article suggests that IV ceftazidime 1g on the short interval days and 2g on the long stretch will be adequate for organisms with a higher MIC. Personally, our centre uses IV ceftazidime 2g at the end of each dialysis session… it might cost a little more for medication administration but it minimizes incorrect dosing / potential for drug levels to go below MIC for an extended period of time (re: patients with residual kidney function, etc). We have not seen toxicity (ie seizures) in almost 10 years experience dosing it at a higher amount. (NB: the renal pharmacists at our site are the antimicrobial stewards — we review all C&S reports and dose antibiotics accordingly).
Hope that helps.
PS Tell us what you ended up doing / any success or pitfalls with what you decided.
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