Penicillin G


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 (EGFR)

0 - 10 eGFR

0.5-4MU IV q12h

10 - 50 eGFR

0.5-4MU IV q8h

50+ eGFR

0.5-4MU IV q4h

Intermittent Dialysis

Up to 2 million units IV q4h- administer after dialysis on HD days. Pharmacist review recommended

Continuous Dialysis

2 million units IV q4h