considering further dose(s)

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Presentation transcript:

considering further dose(s) Starting dose Normal renal function 5 mg/kg (max. 500 mg) (round to nearest 40 mg) Patient >70 years OR estimated GFR 20-40 ml/min 3 mg/kg (round to nearest 40 mg) Significant renal impairment Estimated GFR < 20 ml/min 2 mg/kg (round to nearest 40 mg) Stat dose only Level after 18-24 hours Await results before considering further dose(s) Day 1 Start time of 1st dose 1st dose given between 4 am and 8 pm 1st dose given between 8 pm and 4 am Guide to Once Daily Gentamicin Dosing - NUH Clinical Haematology Unit 4am–2pm 2pm-8pm Blood sample1 at 8 am Blood sample1 at 2 pm Blood sample1 at 10 pm Day 2 Notes A ‘pre-dose’ gentamicin level should be taken 18-24 hours after the 1st dose. Target value is < 1 mg/L. Post-dose samples are not required. The 2nd dose can be administered before the assay results are available to patients with stable renal function and good urine output. 2nd & subsequent doses2 at 2 pm (after level) 2nd & subsequent doses2 at 10 pm (after level)