Use ideal body wt and adjusted body wt in obese patients (BMI≥30)
Dosing
**Extended Interval Dosing (Preferred)**
CrCl 40-60 ml/min: 5-7 mg/kg IV Q36-48h
CrCl <40 ml/min: Switch to conventional amikacin dosing
**Conventional Dosing**
CrCl 40-60 ml/min: 1.2-1.5 mg/kg IV Q12-24h
CrCl 20-40 ml/min: 1.5 mg/kg IV Q24h-48h
CrCl<20 (ESRD not on HD): 1-1.5 mg/kg IVQ48h-72h
Dialysis: 3 mg/kg IV x 1, then 1-3 mg/kg IV post-HD
**CRRT**
Give loading dose of 5 mg/kg, then call pharmacy for assistance
Additional Considerations
Recommend to dose per pharmacy. (See HS 1476 policy)
Extended interval dosing allows for high peak to MIC ratios potentially improving efficacy and reducing the risk of nephro- and ototoxicity. An extended interval level is drawn 6 to 14h after start of infusion.