≤ 32 wks PMA and < 1200 g

Renal Dosing

• CrCl 25-50 mL/min: q12h

• CrCl 10 to less than 25 mL/min: q24h

• CrCl less than 10 mL/min: 50% of dose q24-48h. Start with q24h and adjust to q48h as needed, in consultation with pharmacy.