Once daily Gentamicin / Tobramycin dosing and monitoring

Calculate Creatinine Clearance (CrCl) CrCl (mL/min) =     (140 - Age) x Weight (kg)*     815 x serum creatinine (mmol/L)  (x 0.85    for females) * Use lean body weight:   Male: 50 kg + 0.9 kg for each cm > 150cm   Female: 45 kg + 0.9 kg for each cm > 150cm
CrCl > 60 mL/min First dose: 7 mg/kg: septic shock, CF, spinal, burns, and febrile neutropenia. 5 mg/kg: all other patients. Round to nearest 40 mg, up to 640 mg Infuse over 15 mins. take serum level 6-10 hrs after the FIRST dose (see Exceptions). RECORD SAMPLING TIME. interpret level using graph (see below) Repeat level(s) and serum creatinine every 3 days or more frequently if clinically unstable Review drug choice at 7 days if continuing treatment			CrCl < 60 mL/min Obtain Clinical Microbiology Advice Avoid aminoglycoside if possible Exceptions Endocarditis and other use for synergy - 1 mg/kg 8 hourly. Monitor pre-dose trough only. Trough level < 2mg/L.

Gentamicin / Tobramycin serum level interpretation

• Do not use this graph if CrCl < 60mL/min or for 8 hourly dosing (e.g. endocarditis, use for synergy)
• If measured level is outside the target range, contact Clinical Microbiologist on-call on 8222 3123

Approved : RAH Drug Committee       Date: December 1999

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Document URL: http://www.imvs.sa.gov.au/gentamicin.htm
Last modified: Tuesday, 1st February 2005
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