Dosing recommendations are based on creatinine clearance calculated using the Cockcroft-Gault equation.
Do not use eGFR estimates (available on PAS) for drug dosing purposes
To calculate creatinine clearance (CrCl) using the Cockcroft-Gault equation, use the creatinine clearance calculator :
Accurate estimation of CrCl is only possible in patients with STABLE renal function.
In patients with rapidly changing renal function (i.e. ACUTE renal failure), the serum creatinine levels will no longer provide a true reflection of renal function.
Dose adjustment may not be appropriate in ACUTE renal impairment secondary to SEPSIS. In this case it is important to treat the infection aggressively for the first 24hrs and re-check renal function before reducing the dose accordingly.
In 'acute on chronic' renal impairment the initial dose should correspond to the previous level of chronic renal impairment.
CKD 환자에서 헬리코박터 파일로리 제균을 위한 항생제 적정 용량은 다음과 같습니다.
Amoxicillin, clarithromycin이 포함되어 있는 1차 약제의 경우
Amoxicillin은 다음과 같습니다.
REFERENCE 1
[CRCL >30 ]: No change.
[10-29 ml/min]: q8-12h. Do not use 875 mg tablet.
[<10 ml/min]: q24h. Do not use 875mg tablet.
REFERENCE 2
Crcl (ml/min) :Dose
20 – 50 :Normal
10 – 20 :Normal
<10 :250mg to 1g tds (max. 6g per day in endocarditis)
Clarithromycin은 다음과 같습니다.
즉, Crcl (ml/min)이 30이 넘으면 일반적으로 용량 조절이 필요하지 않습니다.
REFERENCE 1
In patients with severe renal impairment (CLCR < 30 mL/min), the dose of clarithromycin should be reduced by 50%. However, when patients with moderate or severe renal impairment are taking clarithromycin concomitantly with atazanavir or ritonavir, the dose of clarithromycin should be reduced by 50% or 75% for patients with CLCR of 30 to 60 mL/min or < 30 mL/min, respectively.
REFERENCE 2
Crcl (ml/min) :Dose
30 – 50 :Normal
10 – 30 :Oral: 250 - 500mg every 12 - 24 hours - IV: 250 - 500mg every 12 hours
<10 :Oral: 250mg every 12 - 24 hours - IV: 250mg every 12 hours
