💉 Aminoglycoside Empiric Dosing
Gentamicin, tobramycin and amikacin high-dose extended-interval (once-daily) empiric dosing by dosing weight and creatinine clearance. Browser-side, instant.
Aminoglycoside Empiric Dosing
Drug
Dosing weight (kg)
Creatinine clearance (CrCl) (mL/min)
When to use
Choose an empiric once-daily aminoglycoside dose and interval; requires TDM with a random level and the Hartford nomogram.
How it works
Gentamicin/tobramycin 5–7 mg/kg, amikacin 15 mg/kg; interval by CrCl (≥ 60 q24h, 40–59 q36h, 20–39 q48h). Dosing weight = IBW, or AdjBW if actual > 120% IBW.
Key points
- CrCl < 20 or dialysis is unsuitable for extended-interval dosing — use conventional/level-guided dosing.
- Obtain a random level 6–14 h after the first dose and set the interval by nomogram.
- Target troughs: gentamicin/tobramycin < 1, amikacin < 4 mg/L.
- Monitor for nephro- and ototoxicity; avoid other nephrotoxins.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.