Amoxicillin-clavulanate
Renal

Renal

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

CrCl 0-10 mL/min

Oral: 250-500 mg PO q24h of amoxicillin component IV: 1 g followed by 500 mg IV q12-24h of amoxicillin component (5:1 ratio)

CrCl 10-30 mL/min

Oral: 250-500 mg PO q12h of amoxicillin component IV: 1 g followed by 500 mg IV q12h of amoxicillin component (5:1 ratio)

CrCl greater than 30 mL/min

No dosage adjustment necessary

Intermittent Dialysis

Oral: 250-500 mg po q12-24h of amoxicillin component

IV: 1 g followed by 500 mg IV q12-24h of amoxicillin component (5:1 ratio)

Peritoneal Dialysis

Oral: 250-500 mg PO q12h of amoxicillin component

IV: 1 g followed by 500 mg IV q12h of amoxicillin component (5:1 ratio)