Antimicrobial dosing considerations in critically ill patients with acute kidney injury: A review

Table 2 Pharmacokinetic/pharmacodynamic profiles and continuous kidney replacement therapy dosing recommendations for selected antivirals

Antivirals	PK/PD index	PK profile	Renal clearance (%)	Suggested CKRT dosing
Acyclovir	No data	MW: 225; PB: 15%; Vd: 0.8 L/kg	62-91	5-10 mg/kg/dose IV every 12-24 hours (high-flux dialyzers and effluent flow rates of 20-25 mL/kg/hour)
Ganciclovir	No data	MW: 255; PB: 1%-2%; Vd: 0.7 L/kg	80-99	2.5 mg/kg/dose IV every 24 (induction dose)
Foscarnet	No data	MW: 300; PB: 14%-17%; Vd: 0.5 L/kg	28 as unchanged in the urine	30 mg/kg IV every 12 hour (CVVH; hemofiltration rate of 3000 mL/hour)[74]
Oseltamivir[75]	No data	Oseltamivir carboxylate; MW: 284.4; PB: 3%; Vd: 23 L	> 99	75 mg once a day (CVVHD; effluent flow rates used in the study (3300 ± 919 mL/hour)
Remdesivir	No data	MW: 602.6; PB: 88%-93.6%; Vd: Low tissue distribution	Remdesivir: 10; GS-441524: 49	200 mg IV loading dose, followed by 100 mg daily

Pharmacokinetic/pharmacodynamic profiles and continuous kidney replacement therapy dosing recommendations for selected antivirals[98,99]. PK: Pharmacokinetic; PD: Pharmacodynamic; CKRT: Continuous kidney replacement therapy; MW: Molecular weight; Vd: Volume of distribution; CVVHD: Continuous veno-venous hemodialysis; CVVH: Continuous veno-venous hemofiltration.