In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.
If worsening renal function, actual GFR is likely lower than calculated.
If improving renal function, actual GFR is likely higher than calculated eGFR.
Not On Dialysis: Standard Dose
500mg IV q24h
500mg IV q12h
500mg IV q8h
500mg IV q6h
Not On Dialysis: Meningitis Dose
1g IV 24h
2g IV q12h
2g IV q12h
2g IV q8h
Intermittent Dialysis
500mg IV q24h
Dose after HD on dialysis days
Continuous Dialysis
1g IV q8h
Depends on flow rate