Aminoglycoside monitoring

Top Previous Next

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