Penicillin G:
Intravenous penicillin
ECMO Dose Adjustment:
YES—in the absence of published data, dose at the higher end of the normal dosing range due to potential for sequestration based on drug characteristics. Monitor for clinical efficacy and toxicity
Renal Impairment Dose Adjustment*:
YES—a decreased dose may be warranted in some patients
CRRT Dose Adjustment:
YES—the dose may need to be increased relative to the renal impairment dose
Hepatic Impairment Dose Adjustment:
NONE
Adult Dose:
24 million units/day IV divided every 4 hours or as continuous infusion
Pediatric Dose1:
100,000-300,000 units/kg/day IV divided every 4-6 hours, maximum 4 million units/dose, 24 million units/day
Neonatal Dose2:
50,000 units/kg/dose IV
Gestational Age ≤ 34 weeks:
Gestational Age > 34 weeks:
*Dose adjustment will be dependent on acuity and severity of impairment
1Meningitis: 300,000 to 400,000 units/kg/day IV divided every 4 hours
2Meningitis: Postnatal Age ≤ 7 days: 150,000 units/kg/dose IV every 6 hours; Postnatal Age > 7 days: 125,000 units/kg/dose IV every 6 hours