Use ideal body weight for dosing in most cases.
Use adjusted body weight for obese patients (BMI ≥ 30 kg/m²)
Aminoglycoside dosing & monitoring per pharmacy available. Order in CareConnect.
15-20 mg/kg/dose IV Q24h
10-15 mg/kg/dose IV Q36h
10-15 mg/kg/dose IV Q48h
Extended dosing allows for high peak to MIC ratios potentially improving efficacy and reducing the risk of nephro- and ototoxicity. An extended-interval level drawn between 6-14 hours (after the start of the infusion) is recommended any time after the first dose. Peak levels are not necessary and trough levels should be undetectable. Call pharmacy for assessment of aminoglycoside levels.
7.5 mg/kg/dose IV Q12h
5-7.5 mg/kg/dose IV Q12-Q24h
5 mg/kg/dose IV Q24h-Q48h
2.5-5 mg/kg/dose IV Q48h-Q72h
Target amikacin levels: PEAK = 25-35 mg/L and TROUGH = < 5 mg/L. Peak levels should be drawn ½ hour following a ½ hour infusion. Trough levels should be obtained prior to the fourth dose of the regimen.
5 - 7.5 mg/kg IV PHD
10 mg/kg x1 then 5 - 7.5mg/kg IV Q24-48h