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1 local source card selected. Local card fingerprints checked where supplied. This is not an original-document hash, source-currency guarantee or clinical approval. Record-level cautions below are the current library's cautions, not a frozen prior version.
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Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
Opening and detailed source regimens are retained separately where wording differs. Historical infection regimens are not labeled current guideline therapy.
CrCl mL/min; intermittent HD separated from CVVHD.
Source revision
Source revision date not established in selected retrieval.
Retrieved
2026-09-07
Local review status
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Documented differences and cautions on this drug
All record notes are retained here, including notes about sources not selected in this review.
Nondialysis percentage differs below CrCl 10
The RX table retains 50% of the indication dose at CrCl <=50 without dialysis. UCSF separates CrCl <10 and uses 25%. Its continuous-dialysis guidance is specifically qualified by CVVHD evidence.
What to reconcile: Select one applicable complete regimen. Do not combine a label percentage with a different institutional dialysis interval.
Renal method: CrCl mL/min; intermittent HD separated from CVVHD. Source date: Source revision date not established in selected retrieval. Retrieved: 2026-09-07
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Renal dosing, restrictions and evidence limits
Nondialysis: CrCl 10-50, 50% of the indication-specific target dose daily; CrCl <10, 25% daily. The normal-function targets shown are 100 mg/day for oropharyngeal infection, 200 mg/day for esophageal infection and 400 mg/day for heme-BMT prophylaxis.
For severe infection in intermittent HD: 400 mg IV/PO once, then post-HD. The continuous-HD severe-infection schedule is 800-1200 mg/day divided every 12-24 hours. This higher-dose guidance is based on CVVHD; it has not been evaluated for other continuous modalities such as CVVH. Do not generalize it to every CRRT prescription.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh v6.6 | RDM66-DIRECT-PHP-20260911 | Local library date 2026-09-11. Selected-card identity does not imply clinical verification.