Renal dosing of Co-trimoxazole

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Co-trimoxazole IV and PO: Dose adjustment for renal impairment.

Cockcroft-Gault 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.

Crcl (ml/min)	Dose (Treatment doses only)
30 – 50	Normal
15 – 30	PCP: Normal dose for 3 days then 50% of normal dose at normal frequency Other infections: 50% of normal dose at normal frequency
<15	50% of normal dose at normal frequency

No dose reductions required for prophylaxis.

Monitor sulfamethoxazole levels, Contact microbiology for advice on assays

Refer to renal pharmacist for advice on dosing in haemodialysis and peritoneal dialysis.

Refer to critical care pharmacist for advice on dosing in CVVH.

Page last edited: 28/04/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.