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Dosing (adult) of oral antibiotics used in peritoneal catheter exit-site and tunnel infections

Dosing (adult) of oral antibiotics used in peritoneal catheter exit-site and tunnel infections
Amoxicillin 250 to 500 mg two times per day
Cephalexin 500 mg two to three times per day
Ciprofloxacin* 250 to 500 mg two times per day
Clarithromycin 500 mg loading dose, then 250 mg once or two times per day
Clindamycin 300 to 450 mg three to four times per day
Dicloxacillin 500 mg four times per day
Erythromycin 500 mg four times per day
Flucloxacillin (or cloxacillin) 500 mg four times per day
Fluconazole 200 mg once per day for two days, then 100 mg once per day
Flucytosine 0.5 to 1 g/day titrated to response and serum trough levels (25 to 50 mcg/mL)
Isoniazid 200 to 300 mg once per day
Linezolid 400 to 600 mg two times per day
Metronidazole 400 mg three times per day
Moxifloxacin* 400 mg once per day
Ofloxacin* 400 mg first day, then 200 mg once per day
Pyrazinamide 25 to 35 mg/kg up to 3 g per dose three times per week
Rifampin (rifampicin)Δ

Patients weighing less than 50 kg: 450 mg once per day

Patients weighing greater than or equal to 50 kg: 600 mg once per day
Trimethoprim-sulfamethoxazole (co-trimoxazole) 80 to 400 mg (one single-strength tablet) once per day
* Slowly resolving or recurrent Pseudomonas exit-site infections should be treated with a second antipseudomonal drug. Refer to UpToDate topics on tunnel and peritoneal catheter exit site infections in continuous peritoneal dialysis.
¶ The preferred dose for ciprofloxacin is 250 mg two times per day. 500 mg two times per day may be used for patients who have significant residual renal function or are very large.
Δ Rifampin (rifampicin) is reserved for combination treatment with an oral penicillin or first-generation cephalosporin for slowly resolving and severe Staphylococcus aureus exit-site infections. Due to rapid emergence of resistance, rifampin is not appropriate for use as a single agent.
Adapted with permission from: Li PK, Szeto CC, Piraino B, et al. Peritoneal Dialysis-Related Infections Recommendations: 2010 Update. Perit Dial Int 2010; 30:393. Published in Peritoneal Dialysis International. Copyright © 2010.
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