Some infections require treatment with a higher-dose of antibiotic. This could be because certain pathogens require a higher concentration of antibiotic to exert maximal effect (e.g. Pseudomonas and Ciprofloxacin) or because of how much antibiotic reaches a certain site in the body e.g. β-lactams and CNS infection.  

When considering use of an antibiotic that has been reported as “Sensitive at High Dose” against a pathogen, please use the following table. Note that these doses are for normal renal and hepatic function. Please use appropriate resources e.g Renal Drug Database, BNF for dose adjustment in patients with altered renal and/or hepatic function or discuss with clinical pharmacist.


High Dose Therapy

 Amoxicillin IV  2g 4 hourly
 Amoxicillin PO  1g 8 hourly
 Aztreonam IV  2g 6 hourly​
 Co-amoxiclav IV  1.2g 8 hourly PLUS Amoxicillin 1g IV 8 hourly 
 Co-amoxiclav PO  625mg 8 hourly PLUS Amoxicillin 500mg 8 hourly
 Cefuroxime IV    1.5g 8 hourly
 Cefuroxime PO  500mg 12 hourly
 Ceftazidime IV  2g 8 hourly
 Ceftriaxone IV  2g 12 hourly or 4g daily
 Ciprofloxacin IV
 400mg 8 hourly
 Ciprofloxacin PO  750mg 12 hourly
 Co-trimoxazole IV / PO  1.44g 12 hourly 
 Fluconazole IV / PO  800mg daily
 Levofloxacin IV / PO  500mg 12 hourly
 Piperacillin-Tazobactam (Tazocin) IV  4.5g 6 hourly

 Temocillin      - CrCl (ml/min)  > 60 

                          - CrCl (ml/min)  40-60

                          - CrCl (ml/min)  20-40

                          - CrCl (ml/min)  < 20

 2g 8 hourly

 2g 12 hourly

 2g stat then 1g 12 hourly

 2g stat then 1g 24 hourly