Tobramycin - Renal Dosing

CrCl > 60 ml/min

No dose adjustment necessary

CrCl 40-60 ml/min

5-7 mg/kg IV every 36 hr

CrCl 20-39 ml/min

5-7 mg/kg IV every 48 hr

CrCl <20 ml/min

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CrCl > 60 ml/min

No dose adjustment necessary

CrCl 40-60 ml/min

1.5-2 mk/kg IV every 12-24 hr

CrCl 20-39 ml/min

1.5-2 mg/kg IV every 24-48 hr

CrCl < 20 ml/min

1.5-2 mg/kg IV every 48-72 hr

3 mg/kg IV load

Mild infection/Synergy
1 mg/kg IV every 48-72 hr Post HD

Severe infection
2 mg/kg IV every 48-72 hr Post HD

Usual dosing
3 mg/kg IV load then 2mg/kg IV every 24 hr

Synergistic dosing
1 mg/kg IV every 24 hr