💉 Aminoglycoside Empiric Dosing
Gentamicin, tobramycin and amikacin high-dose extended-interval (once-daily) empiric dosing by dosing weight and creatinine clearance. Browser-side, instant.
Clinical takeaway
CrCl < 20 or dialysis is unsuitable for extended-interval dosing — use conventional/level-guided dosing.
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When to use
Choose an empiric once-daily aminoglycoside dose and interval; requires TDM with a random level and the Hartford nomogram.
How it works
Gentamicin/tobramycin 5–7 mg/kg, amikacin 15 mg/kg; interval by CrCl (≥ 60 q24h, 40–59 q36h, 20–39 q48h). Dosing weight = IBW, or AdjBW if actual > 120% IBW.
Key points
- CrCl < 20 or dialysis is unsuitable for extended-interval dosing — use conventional/level-guided dosing.
- Obtain a random level 6–14 h after the first dose and set the interval by nomogram.
- Target troughs: gentamicin/tobramycin < 1, amikacin < 4 mg/L.
- Monitor for nephro- and ototoxicity; avoid other nephrotoxins.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Frequently asked questions
- What is Aminoglycoside Empiric Dosing?
- Gentamicin, tobramycin and amikacin high-dose extended-interval (once-daily) empiric dosing by dosing weight and creatinine clearance. Browser-side, instant.
- How is Aminoglycoside Empiric Dosing calculated? What is the core formula?
- Gentamicin/tobramycin 5–7 mg/kg, amikacin 15 mg/kg; interval by CrCl (≥ 60 q24h, 40–59 q36h, 20–39 q48h). Dosing weight = IBW, or AdjBW if actual > 120% IBW.
- When is Aminoglycoside Empiric Dosing used?
- Choose an empiric once-daily aminoglycoside dose and interval; requires TDM with a random level and the Hartford nomogram.
- What are the key clinical points for Aminoglycoside Empiric Dosing?
- CrCl < 20 or dialysis is unsuitable for extended-interval dosing — use conventional/level-guided dosing. Obtain a random level 6–14 h after the first dose and set the interval by nomogram. Target troughs: gentamicin/tobramycin < 1, amikacin < 4 mg/L. Monitor for nephro- and ototoxicity; avoid other nephrotoxins.
- What are the limits and cautions when using Aminoglycoside Empiric Dosing?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.