Tobramycin - Renal Dosing

In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.

If worsening renal function, actual GFR is likely lower than calculated.

If improving renal function, actual GFR is likely higher than calculated eGFR.

0 - 20 eGFR

2mg/kg load then dose as per levels

20 - 39 eGFR

1.7mg/kg q24h

40 - 59 eGFR

1.7mg/kg IV q12h

60+ eGFR

1.7mg/kg q8h

0 - 40 eGFR

AVOID use. If necessary, use conventional aminoglycoside dosing

40 - 59 eGFR

5-7mg/kg q36h

60+ eGFR

5-7mg/kg q24h

2mg/kg load post HD, then 1.5mg/kg post HD

3mg/kg IV load then 2mg/kg IV q24h