Amikacin
Renal

Renal

Not On Dialysis: Once Daily

Use indication-specific weight-based dosing

eGFR < 10

Administer Q48-72H based on serum levels Only use if no alternatives

eGFR 10 - 50

Administer Q48-72H based on serum levels Only use if no alternatives

eGFR > 50

No adjustments necessary

Patients with tuberculosis

15 mg/kg 2-3 times weekly

Intermittent Dialysis

Avoid aminoglycosides in renal failure patients if possible.

Use 5-7.5 mg/kg Q48-72H after dialysis for each intra-dialitic period.

Check levels pre-dialysis.

Readminister post dialysis if pre-HD level is less than 10 mg/L -OR- if post-HD level is <6-8 mg/L

Continuous Dialysis

10 mg/kg load then 7.5 mg/kg Q24-48H

  • For severe gram-negative infections, target peak concentration 15-30 mg/L. Re-administer if level is <10 mg/L

Peritoneal Dialysis

Intermittent dosing

2 mg/kg per exchange Q24H

  • Allow to dwell at least 6 hours
Continuous dosing (all exchanges)

Loading dose of 25 mg/L Maintenance dose of 12 mg/L