What is the dosing of aminoglycosides?
A dose of 5-7 mg/kg of gentamicin, tobramycin, or netilmicin, with at least a 24 h dosing interval should be employed and a similar regimen can be applied to amikacin dosing.
What is conventional dosing?
Traditional/conventional dosing refers to multiple daily doses of aminoglycosides (e.g. tobramycin or gentamicin dosed 80mg every 8 hours or 1.5-2.5 mg/kg every 8 hours). Of the two approaches, EIAD is preferred over traditional dosing in patients that meet EIAD eligibility criteria.
When is the peak drawn for conventional dosing of gentamicin?
Peak levels can be obtained 60 minutes after start of infusion c. Gentamicin / Tobramycin i. Loading dose of 2 – 3 mg/kg once daily, followed by 1. UTI/Synergy: 1 mg/kg every 24 – 36 hours a.
Why are aminoglycosides dosed once daily?
Summary: Although administration of multiple daily doses remains the standard method of aminoglycoside dosing, once-daily dosing may provide enhanced clinical efficacy and reduced toxicity in selected patient populations; demonstrated pharmacokinetic and pharmacodynamic advantages include enhanced postantibiotic effect …
How are aminoglycosides administered?
Because aminoglycosides are normally used to treat serious infections, they are typically administered into the veins of the body (intravenously, or IV). However, some aminoglycosides can be taken orally, or as ear or eye drops.
When do you need aminoglycoside levels?
Maintenance random levels should be monitored at least once weekly. If duration of therapy is anticipated to be > 2 weeks, audiometry should be considered. Single level drawn 8 – 12 hours after the first dose.
What is vancomycin peak and trough?
Vancomycin is an antibiotic drug used to treat serious, life-threatening infections by gram-positive bacteria that are resistant to less-toxic agents. The reference range for vancomycin trough levels is 5-15 mcg/mL. The reference range for vancomycin peak levels is 20-40 mcg/mL.
Can amikacin be given once daily?
For elderly patients a smaller dose of amikacin than the regular daily dose of 15 mg/kg bw, i.e. about 11 mg/kg bw, seems recommendable, when it is given once daily. From the data obtained it is also obvious that once-daily dosing of amikacin does not eliminate the need for checking serum concentrations of the drug.
When do you use peak and trough for gentamicin?
Peak levels are typically evaluated 30 minutes after completion of the infusion. Trough levels should be drawn immediately before the dose is administered.
How does the once-daily dosing affect aminoglycoside toxicity?
Although once-daily dosing of aminoglycosides may result in a period of up to 12 h during which there are no detectable serum concentrations of the drug, the post-antibiotic effect of the aminoglycosides allows for once-daily dosing without compromising therapeutic efficacy.
Why is gentamicin given once a day?
Aminoglycosides are usually given in two or three divided doses. A once-daily regimen might be more effective and less toxic.
When to draw gentamicin trough?
The trough sample is drawn immediately prior to the next dose. Peak samples should be drawn 45 to 60 minutes after an IM injection , 30 minutes after the end of a 30-minute IV infusion , or immediately after a 60-minute IV infusion.
When to check gentamicin trough?
Pre-dose (trough) gentamicin levels should be checked after 24 hours and then twice weekly (target <1mg/L). Peak gentamicin levels, taken one hour after administration, can also be measured (target 3–5mg/L). Individualised dosing based on the patient’s pharmacokinetics can also be used.
How often are gentamicin troughs?
The most commonly used dose is 80mg three times daily. Pre-dose (trough) gentamicin levels should be checked after 24 hours of treatment (target <2mg/L) and peak levels measured one hour post-dose (target 5–10mg/L). Some infections, such as Pseudomonas spp.may require an increased dose to achieve higher peak levels.