Therapeutic drug Monitoring (TDM)
TDM is not necessary if therapy is anticipated to stop at 36-48 hours.
A trough level can be obtained just prior to the anticipated second dose but may be postponed to pre-third dose if there is no concern for renal dysfunction and if it is anticipated that the duration will be ≤ 48 hours. Trough levels are then usually obtained before every subsequent third dose of aminoglycosides.
Target for Trough concentrations:
<2.0 mg/L
Peak concentrations are not routinely needed unless for purposes of pharmacokinetic modelling or efficacy.
If renal dysfunction is present, consult clinical pharmacist as longer dosing intervals and/or lower doses may be required if the aminoglycoside is to be continued.
Considerations for Renal Dysfunction or Acute HIE/Asphyxia