腎功能不全者抗菌藥的應(yīng)用表

腎功能不全者抗菌藥的應(yīng)用表藥物半減期（h）正常時(shí)劑量給藥方式按Ccr(ml/min)給藥(%)血透時(shí)用藥腹透時(shí)用藥正常無(wú)尿減量延長(zhǎng)間期>50-9010-50<101.正常劑量或劑量稍減少紅霉素1.45-60.25-0.5gq6h+10010050-70－－利福平1.5-51.8-110.6g/d+10050-10050－0.1g/d多西環(huán)素18.520.90.2g/d+10010050－－氨芐西林1.07-200.25-2gq6h+q6hq6-12hq12-24h－0.25gq12h阿莫西林1.05-200.25-0.5gq8h+q8hq8-12hq24h－0.25gq12h氨芐西林/舒巴坦1/19/102g/1gq6h+q6hq8～12hq24h－2g/1gq24h哌拉西林1.03.3-5.13-4gq4-6h+q4-6hq6-8hq8h－按Ccr<10頭孢哌酮1.6-2.42.21.4gq6-12h+10010050透析后1g－頭孢曲松812-15.71.2gq12-24h+10010050－－哌拉西林－他唑巴坦1/13/43.375gq6h++3.375gq6h2..25gq6h2.25gq8h透析后0.75g按Ccr<10利奈唑胺6.47.1q0.6g12h0.6gq12h0.6q12h透析，0.6q12h按Cer<10－環(huán)丙沙星46-90.5-0.75po0.4ivq12h+10050-75500.2gq12h0.2gq8h甲硝唑6-147-217.5mg/kgq6h+10010050－按Ccr<10兩性霉素B24240.3-0.8mg/kg·d+去24hq24hq24-48h－按Ccr<10伊曲康唑21250.1-0.2gq12h+100100500.1q12h-24h0.1q12h-24h異菸肼0.7-48-175mg/kg·d+10010050－<50%乙胺丁醇47-1515mg/kgq24h+去24hq24-36hq48h－按Ccr<10乙硫異菸肼2.1?0.25-0.5gq12h+10010050－－2.劑量需適度減少青霉素0.56-200.5-4百萬(wàn)單位q4h+1007520-50－按Ccr<10替卡西林1.2133gq4h++1-2gq4h1-2gq8h1-2gq12h透析后3g按Ccr<10頭孢唑啉1.940-701-2gq8h+q8hq12hq24-48h透析后0.5-1g0.5gq12h頭孢呋辛1.2170.75-1.5gq8h+q8hq8-12hq24h－按Ccr<10頭孢噻肟頭孢唑肟1.715-352gq8h+q8-12hq12-24hq24h透析后1g0.5-1gqd頭孢他啶1.213-252gq8h+q8-12hq24-48hq48h透析后1g0.5gqd頭孢吡肟2.2182gq12h++2gq12h2gq12-24h1gq24h透析后1g1-2gq48h替卡西林－克拉維酸1/113/43.1gq4h++3.1gq4h2gq4-8h2gq12h透析后3.1g3.1gq12h頭孢西丁0.813-232gq8h+q8hq8-12hq24-48h透析后1g1gqd頭孢替坦3.513-251-2gq12h+1005025透析后1g1gqd亞胺培南140.5gq6h++0.25-0.5gq6-8h0.25gq6-12h0.125-0.25gq12h－按Ccr<10美洛培南16-81gq8h++1gq8h1gq12h0.5gq24h－按Ccr<10厄他培南4>41gq24h+1gq24h0.5gq24h0.5gq24h按Ccr<10氨曲南26-82gq8h+10050-7525透析后0.5g按Ccr<10克拉霉素5-7220.5-1gq12h+1007550-75－－替考拉寧4565-2306mg/kg.d+q24hq48hq72h按Ccr<10按Ccr<10氧氟沙星728-370.4gq12h+1005025-500.1gbid按Ccr<10左氟沙星6-51760.75gqd++100首劑0.75每日，隔日0.25首劑0.750.5qod按Ccr<10按Ccr<10加替沙星7-1436400mgqd+400mgqd首劑400mg以后200mgqd同左透析后0.2g0.2gqd磺胺甲噁唑1020-501gq8h+q12hq18hq24h透析后1g1gqd甲氧芐啶1120-490.1-0.2gq12h+q12hq18hq24h透析后不加0.1gq24h氟康唑371000.2-0.4g/d+1005050透析后0.2g按Ccr<103.劑量需嚴(yán)格減少慶大霉素妥布霉素2-320-601.7mg/kgq8h++60-90q8-12h30-70q12h20-30q24-48h透析后1/2常規(guī)量按每升透析液補(bǔ)3-4mg阿米卡星1.4-2.317-1507.5mg/kgq12h++60-90q12h30-70q12-18h20-30q24-48h透析后1/2常規(guī)量按每升透析液補(bǔ)15-20mg奈替米星2-335-722mg/kgq8h++50-90q8-12h20-60q12h10-20q24-48h透析后1/2常規(guī)量按每升透析液補(bǔ)3-4mg鏈霉素2-330-8015mg/kgqd+50,qdq24-72hq72-96h透析后1/2常規(guī)量按每升透析液補(bǔ)20-40mg萬(wàn)古霉素6200-2501gq12h++1gq6-12h1gq24-96h1g/4-7d按Ccr<10按Ccr<10多粘菌素E﹤64880-160mgq8h+160mgq12h160mgq24h160mgq36h透