Gent, Vanc, Amik (Adults)

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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 Gentamicin Guideline

Gentamicin Calculator

KDIGO AKI Definition

Assessing Renal Function

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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.