Aminoglycoside monitoring

 

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1.  Monitoring parameters:

Aminoglycoside peak and trough levels

Obtain levels 24 hours after initiating therapy, at steady state (approximately four half-lives), and every 2 to 3 days. For extended interval dosing method, obtain mid-interval drug level 6 to 14 hours after the initial dose and repeat drug level 1-2 times weekly. Patients with fluid shifts may need more frequent monitoring.

BUN and serum creatinine

Measure every two days, or every day in unstable renal function.

Weigh patient every two to seven days.
Measure and monitor urine output daily.
Baseline and weekly audiograms, and check for tinnitus or vertigo daily.

 

 

2.  Therapeutic serum concentrations (mcg/ml)

Gent/Tobra/Netilmicin

Peak

Serious infection: 6-8

Life-Threatening infection: 8-10

Trough

Serious infection: 0.5-1.5

Life-Threatening infection: 1- <2

 

Amikacin/Kanamycin

Peak

Serious infection: 20-25

Life-Threatening infection: 25-30

Trough

Serious infection: 1-4

Life-Threatening infection: 4-8

 

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