|
|
|
| Antibiotics |
Indications |
Ccr
≧50
|
Ccr
20-49
|
Ccr
10-19
|
Ccr
<10
|
HD |
| Acyclovir |
Varicella zoster virus infection |
10-15 mg/ kg Q8H
|
10-15 mg/ kg Q12H |
10-15 mg/ kg QD |
5-7.5 mg/ kg QD |
5-7.5 mg/ kg QPM |
| |
Herpes simplex infection |
5 mg /kg Q8H |
5 mg /kg Q12H |
5 mg /kg QD |
2.5 mg /kg QD |
2.5 mg /kg QPM |
| |
Herpetic meningitis |
10-15 mg/ kg Q8H |
10-15 mg/ kg Q12H |
10-15 mg/ kg QD |
5-7.5 mg/ kg QD |
5-7.5 mg/ kg QPM |
|
|
TOP↑
|
|
| Antibiotics |
Indications |
Ccr
≧50
|
Ccr
30-49
|
Ccr
10-29
|
Ccr
<10
|
HD |
| Valacyclovir |
Varicella zoster virus infection |
1gm Q8H
|
1gm Q12H |
1gm QD |
0.5gm QD |
0.5gm QPM |
| |
Herpes simplex infection |
1gm Q12H |
1gm Q12H |
1gm QD |
0.5gm QD |
0.5gm QPM |
|
|
TOP↑
|
|
| Antibiotics |
Indications |
Ccr
≧70
|
Ccr
50-69
|
Ccr
25-49
|
Ccr
10-24
|
Ccr
<10
|
HD |
| Ganciclovir |
Induction dose
|
5 mg/kg Q12H
|
2.5 mg/kg Q12H |
2.5 mg/kg QD |
1.25 mg/kg QD |
1.25 mg/kg TIW
|
1.25 mg/kg TIW |
| |
Maintenance dose |
5 mg/kg QD |
2.5 mg/kg QD |
1.25 mg/kg QD |
0.625 mg/kg QD |
0.625 mg/kg TIW |
0.625 mg/kg TIW |
| |
CMV retinitis |
5 mg/kg Q12H |
2.5 mg/kg Q12H |
2.5 mg/kg QD |
1.25 mg/kg QD |
1.25 mg/kg TIW |
1.25 mg/kg TIW |
|
|
TOP↑
|
|
| Antimicrobial agent |
Indications |
Ccr
≧60
|
Ccr
40-59
|
Ccr
25-39
|
Ccr
10-24
|
Ccr
<10
|
HD |
| Valganciclovir |
Induction dose
|
900 mg Q12H
|
450 mg Q12H |
450 mg QD |
450 mg QOD |
*Not recommended
|
*Not recommended |
| |
Maintenance dose |
900 mg QD |
450 mg QD |
450 mg QOD |
450 mg BIW |
*Not recommended |
*Not recommended |
| |
Prophylaxis in solid organ transplant |
900 mg QD |
450 mg QD |
450 mg QOD |
450 mg BIW |
*Not recommended |
*Not recommended |
|
*may consider using oral solution 200 mg 3 times weekly
CMV retinitis: Induction: 900 mg twice daily for 14 to 21 days followed by maintenance therapy
|
|
|
TOP↑
|
|
| Antimicrobial agent |
Indications |
Ccr ≧10
|
Ccr <10
|
HD |
| Letermovir |
Transplant prophylaxis |
480 mg
QD
|
No recommendations |
No recommendations |
|
Letermovir is not recommended in severe impairment (Child-Pugh class C)
|
TOP↑
|
|
| Antimicrobial agent |
Indications |
Ccr ≧10 |
Ccr <10 |
| Maribavir |
CMV infection |
400 mg
BID
|
400 mg
BID
|
|
|
TOP↑
|
| |
| 附註：所提供資訊不能取代醫師之治療及醫師與病患之關係 |