Empiric (in combination) or targeted therapy for suspected or confirmed Gram negative infections.
Empiric therapy for pyelonephritis.
Used synergistically in Gram positive infections (e.g Enterococcus spp. endocarditis)
Monitor serum creatinine, BUN 2-3 times/week. Discontinue if any signs of ototoxicity.
For once daily/extended interval dosing dosing:
A single serum concentration can be drawn between 6 to 14 hours after the start of the aminoglycoside infusion (typically a 8-10 hour post concentration is drawn.)
For conventional multiple times per day dosing:
NB: Trough level is 30-60min BEFORE next dose dose, and peak is 30-60min AFTER dose infused.
For Gram-positive synergy dosing:
For Intermittent OR Continuous dialysis:
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Can exacerbate neuromuscular blockade
Increased nephrotoxicity
Increased ototoxicity
Non-depolarizing muscle relaxants may be potentiated
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 2 hours
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic
Calculation of Dosing Body Weight (DBW) DBW = IBW + [(ABW - IBW) x 0.4]
where: IBW male = 50kg + 0.906kg [Height (cm) - 152.4cm] IBW female = 45kg + 0.906kg [Height (cm) - 152.4cm]
Dosing Body Weight = DBW Ideal Body Weight = IBW Actual Body Weight = ABW