ICU Medication Calculator for COVID-19

This calculator is to estimate ICU medication requirements for critical patients with confirmed COVID-19. At this time, there is no approved vaccine or specific proven treatments for the virus, so these medications focus on secondary complications that may arise. The medications and dosing are based on IDSA guidelines for community-acquired pneumonia, hospital-acquired pneumonia, and septic shock. Direct Relief is using this tool for purposes of maintaining stock levels and producing standard modules that could be deployed rapidly based on the number COVID-19 patients.

# Confirmed COVID-19 ICU Patients:
# Days of treatment:
Medication Amount/day Days Total Needed Unit Dosing
IV fluids
Plasma-Lyte or NS 1L 5 1 5 bags 30ml/kg bolus + maintenance
Antibiotics
IV antibiotics
Ampicillin/Sulbactam (Unasyn) IV 4 1 4 vials 1.5-3g IVq6h
Azithromycin 500mg IV 1 1 1 vials 500mg IV q24h x2 days then PO
Cefotaxime 1GM IV 12 1 12 vials 2g IV q4-8h
Ceftriaxone 1GM IV 2 1 2 vials 1-2g IV/IM q24h
Doxycycline 100mg IV 2 1 2 vials 100mg IV q12h
Levofloxacin 25mg/mL 30mL IV 1 1 1 vials 750mg IV QD
Piperacillin/tazobactam (Zosyn) IV 4 1 4 vials 4.5g IV q6h
Vancomycin 500mg IV 10 1 10 vials 15-20mg/kg IV q8-12h
PO antibiotics
Amoxicillin/Clavulanate 875/125mg tabs 2 1 2 tab 875/125mg PO BID
Azithromycin 250mg/500mg tabs 1 1 1 tab 500mg PO x1 then 250mg PO q24h x 4 days
Doxycycline 100mg tabs 2 1 2 tab 100mg PO q12h
Levofloxacin 750mg tabs 1 1 1 tab 750mg PO QD
Vasopressors
Norepinephrine 1mg/ml 4ml 10 1 10 vials 0.02-1mcg/kg/min
Vasopressin 20u/mL 1ml 2 1 2 vials 0.01-0.04 units/min
Dopamine 40mg/mL 5mL 10 1 10 vials max 50mcg/kg/min
Antivirals
Remdesivir 100mg IV 1 1 1 vials 200mg IV Day 1 then 100mg IV Day 2-10
Steroids
Dexamethasone 6mg tab 1 1 1 tabs 6mg PO QD x 10 days
Dexamethasone 4mg/mL 1mL 1.5 1 1.5 vials 6mg IV QD x 10 days

Assumptions:

Patients will not be on all listed medications, but each is included to customize to current stock levels and your facility.

Average Patient is 70kg.

References:

https://www.idsociety.org/practice-guideline/community-acquired-pneumonia-cap-in-adults/

https://www.idsociety.org/practice-guideline/hap_vap/

https://www.covid19treatmentguidelines.nih.gov/