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/