Background
Clinical Breakpoints
| Species | ECV (μg/mL) | Breakpoints (μg/mL) | Breakpoints (mm) | ||||
|---|---|---|---|---|---|---|---|
| S | I | R | S | I | R | ||
| Enterobacterales | ≤16/4 | 32/4-64/4 | ≥128/4 | ≥21 | 18-20 | ≤17 | |
| Pseudomonas aeruginosa | ≤16/4 | 32/4-64/4 | ≥128/4 | ≥21 | 15-20 | ≤14 | |
| Acinetobacter | ≤16/4 | 32/4-64/4 | ≥128/4 | ≥21 | 18-20 | ≤17 | |
| Other non-Enterobacterales | ≤16/4 | 32/4-64/4 | ≥128/4 | ||||
| Anaerobes | ≤16/4 | 32/4-64/4 | ≥128/4 | ||||
| Haemophilus influenzae and Haemophilus parainfluenzae | ≤1/4 | — | ≥2/4 | ≥21 | — | — | |
| Gram-positive bacteria | susceptibility predicted by penicillin | ||||||
Dosing
- Standard dose: 3.375 g IV every 6 hours
- Pseudomonas dose: 4.5 g IV every 6 hours
Renal Dosing
| CrCl | Standard | Pseudomonas | Notes |
|---|---|---|---|
| >30 | 3.375 g q6h | 4.5 g q6h | |
| 10-29 | 3.375 g q8h | 4.5 g q8h | |
| <10 | 3.375 g q12h | 4.5 g q12h | |
| PD | 3.375 g q12h | 4.5 g q12h | |
| HD | 3.375 g q12h | 4.5 g q12h | On dialysis days, given towards the end of dialysis |
| CRRT | 3.375 g q6h | 4.5 g q6h | |
| SLED | 3.375 g q12-18h | 4.5 g q12-18h | Depends on severity of illness and intensity of SLED dialysis |
