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) Consult pharmacy if treating pseudomonas

0 - 30 eGFR

2.25 g IV q6 - 8h

30 - 50 eGFR

2.25 - 3.375 g IV q6h

50+ eGFR

No dosage adjustment required.


Extend dosing interval in infants with renal dysfunction. Consult NICU pharmacist for dosing recommendations