Monitor urine output, urinalysis, BUN, serum creatinine, peak and trough amikacin concentrations. Discontinue if any signs of ototoxicity.
Serum level monitoring for conventional dosing: Draw peak levels 30 minutes after the end of the infusion and trough levels within 30 minutes before the next dose. UTI: Peak levels 15-20 mcg/mL and trough < 4 mg/L (if level monitoring is indicated), Serious infections: Peak 20-40 mg/L and trough < 8 mg/L,.
Serum level monitoring for extended-interval dosing: Target trough <2 mg/L; Peak levels not generally recommended.
Consult pharmacist for level interpretation and dose individualization