High-dose Antibiotic Regimens

Antimicrobial prescribing: NHS Fife
NHS Fife

Some infections require higher-dose antibiotic regimens. This may be because of how antibiotics reach the affected site, or because the pathogen present requires a higher concentration of antibiotic to effectively treat it.

When advised to use a high-dose or increased-dose regimen, please use the following table. Note that these doses are for normal renal and hepatic function and you may need to adjust accordingly.

Antibiotic Dose
Amoxicillin IV 2g every 4 hours
Amoxicillin PO 1g every 8 hours
Benzylpenicillin IV 1.2g every 4 hours
Benzylpenicillin IV (meningitis)

Pneumococcal meningitis (Microbiology advice only) 2.4g every 4 hours
Cefalexin PO 1g every 8 hours
Cefotaxime IV 2g every 8 hours
Ceftazidime IV 2g every 8 hours
Ceftriaxone IV

2g every 12 hours OR 4g every 24 hours (meningitis and S. aureus – high dose only)
Cefuroxime IV 1.5g every 8 hours
Ciprofloxacin IV 400mg every 8 hours
Ciprofloxacin PO 750mg every 12 hours
Co-amoxiclav IV

1.2g every 8 hours PLUS Amoxicillin 1g every 8 hours
Co-amoxiclav PO

625mg every 8 hours PLUS Amoxicillin 500mg every 8 hours
Cotrimoxazole PO or IV 1.44g every 12 hours
Flucloxacillin IV 2g every 4 hours
Levofloxacin PO or IV 500mg every 12 hours
Meropenem IV 2g every 8 hours
Piperacillin-tazobactam IV 4.5g every 6 hours
Temocillin IV 2g every 8 hours