Aminoglycoside Dosing & Monitoring
Dosing - MDD

Dosing - MDD

Clinical Considerations

Generally based on ideal body weight (IBW)

EXCEPT for hemodialysis sliding scale dose use patient’s dry weight (this can be found on hemo run sheets)

IBW females = 45.5 + (2.3 x # inches over 5 ft*)
IBW males = 50 + (2.3 x # inches over 5 ft*) males

*If patient is less than 5 ft: use negative inches

e.g. female patient is 4’8’’ (4 inches below 5 feet): IBW = 45.5 + (2.3x (-)4) = 36.3 kg

Dose based on TOTAL body weight

Use an adjusted body weight (ABW)

  • IBW females = 45.5 + (2.3 x # inches over 5 ft*)
  • IBW males = 50 + (2.3 x # inches over 5 ft*) males
  • ABW = IBW + 0.4 (TBW - IBW)

*If patient is less than 5 ft: use negative inches

  • e.g. female patient is 4’8’’ (4 inches below 5 feet): IBW = 45.5 + (2.3x (-)4) = 36.3 kg

Order Set

Review initiation order set 10-111-5336

Dosing

  • Loading dose: 2 mg/kg x 1
  • Maintenance dose: 1.7 mg/kg/dose
  • Synergy dose: 1 mg/kg/dose
  • Loading dose: 2 mg/kg x 1
  • Maintenance dose: 1.7 mg/kg/dose
  • Synergy dose: 1 mg/kg/dose

NOTE: Loading dose needed only in life-threatening infections or in dialysis patients to achieve steady state levels more rapidly (will need to order as one time initial dose then provide sliding scale with maintenance dosing)

Hemodialysis - Sliding Scale

  • Determine patient's dry weight in kg
  1. Draw random (drug) levels prior to EACH hemodialysis

2. Give (drug) doses post hemodialysis

(Drug) Level (Drug) Dose
1.5 Hold (drug)
1 - 1.5 1.7 mg/kg dose less 20 mg
Less than 1 1.7 mg/kg dose (1 mg/kg if synergy)