High Dose Antibiotic Therapy
Antimicrobial prescribing: NHS Forth Valley
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.
Antibiotic |
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 |