It is recommended to use Extended Interval Dosing if possible for optimal bactericidal activity, convenience, potentially reduced risk of nephrotoxicity and reduced cost for administration.
Extended interval aminoglycoside dosing is the preferred dosing regimen but should NOT TO BE USED in the following:
If excluded, refer to Conventional Dosing.
Serum Drug Concentrations Conventional Dosing: Desired trough level: < 8 mg/L Desired peak level: 20 to 30 mg/L
Extended Interval Dosing: Desired trough level: < 1 mg/L
Follow-up Monitoring If therapy is to be continued for greater than 7 days then:
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Can exacerbate neuromuscular blockade- e.g. contraindicated in patients with myasthenia gravis.
Avoid concurrent nephrotoxic or ototoxic drugs (e.g. furosemide) whenever possible
Recommended Calculations
Body weight calculation (kg) ABW = actual body weight IBW = ideal body weight
DBW = dosing body weight
For “non-obese” patients use: ABW For “obese” patients use: DBW
Creatinine clearance (mL/min) CrCl (male) = [(140 – age) x weight x 60] / [50 x serum creatinine (umol/L)]
CrCl (female) = CrCl (male) x 0.85
Age is in years.
Weight (kg) = ABW if non-obese, or = DBW if obese
Antimicrobial class: Aminoglycoside
Pregnancy category: D