Gent, Vanc, Amik (Adults)

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Gentamicin and Vancomycin Calculator

Do NOT use in ICU/ HDU to calculate  Dosing  for Vancomycin Continuous Infusion

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Adult Amikacin Guideline

Amikacin is a reserve aminoglycoside in LH and should only be prescribed on the advice of a Consultant Microbiologist or ID Consultant (except when administered as a single IM dose as part of TRUS biopsy prophylaxis regimen).

  • Dose based on weight and renal function
  • Use actual weight unless BMI > 30kg/m 2
  • If BMI > 30, use Obese Dosing Weight (ODW) to calculate creatinine clearance (CrCl) and amikacin dose
  • Maximum IV amikacin dose 1,500mg daily

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CrCl

Amikacin Dose

> 50mL/min

15mg/kg once daily IV

30 – 50 mL/min

10mg/kg once daily IV

10 – 30 mL/min

5mg/kg once daily IV

< 10 mL/min 3mg/kg STAT IV

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  • Check renal function regularly
  • Check first trough level 18 – 24 hours after first dose
  • Target trough level < 5mg/L
  • Amikacin levels are processed externally – contact Laboratory Referrals directly for result (#2560)
  • Repeat trough level twice weekly if creatinine normal or more often if creatinine abnormal or deteriorating.

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Adult Vancomycin Guideline

Vancomycin Calculator

Do NOT use in ICU/ HDU to calculate  Dosing  for Vancomycin Continuous Infusion

KDIGO AKI Definition

Assessing Renal Function

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References

  • Beaumont Hospital Antimicrobial Guidelines 2018. Available from RCSI Hospitals Antimicrobial Guidelines Smartphone Application, accessed 12/03/18.Obtained with permission from Consultant Microbiologist.

  • CRC Press, Taylor and Francis Group. The Renal Drug Database. Available from www.renaldrugdatabase.com , accessed 9/5/16.

  • John Hopkins ABX Guide, available from www.hopkinsguides.com , accessed 12/03/18.

  • Nicolau DP, Freeman CD, Belliveau PP et al. Experience with a once-daily aminoglycoside program administered to 2,184 adult patients. 1995;39(3):650-655.

  • Rybak M, Lomaestro B, Rotschafer JC et al. Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm 2009;66:82-98.

  • Truven Health Analytics Inc. Micromedex® Medication, Disease and Toxicology Management. Available from www.micromedexsolutions.com , accessed 9/5/16.