Not On Dialysis
CrCl >50 mL/min: 500mg BID
CrCl 30-50 mL/min: 250mg BID
CrCl 10-29 mL/min: 250mg BID
CrCl <10 mL/min: 250mg daily
Intermittent Hemodialysis (IHD)
250mg qPM
500mg qPM
Continuous Ambulatory Peritoneal Dialysis (CAPD)
250mg daily
500mg daily
Note
For all beta-lactams, if patient weighs >30% IBW, consider using upper end of dosing recommendations