I am confuse with the ISPD antibiotic dosing – continuous regimen(mg/l, all exchanges) Do we have a maximum dose the each antibiotics? When should we use the continuous regime and when to use the intermittent dosing?thank you

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Michelle, Scientist from Malaysia asked
I am confuse with the ISPD antibiotic dosing – continuous regimen(mg/l, all exchanges) Do we have a maximum dose the each antibiotics? When should we use the continuous regime and when to use the intermittent dosing?thank you

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The dosing in the ISPD guideline was based on previous publicated literature on pharmcokinetics of individual antibiotics, with a loading and then the maintenance dose. Usually, the drug level is still above MIC at the end of a PD dwell cycle. Publications suggested that intermittent dosing is as good as continuous dosing, so most centers prefer intermittent dosing for easy of administration and possibly less side effects in case of aminoglycosides. Some would prefer continuous dosing for more severe peritonitis or refractory to intermittent therapy, based on common sense rather than evidence.

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