Step 2: Monitor creatinine and gentamicin concentrations and reassess the dosage regimen Aminoglycosides weight-based dosing should be based on ideal or adjusted body weight. Inform midwife/nurse of prescription 7. High-dose Extended-Interval Therapy Rationale: Aminoglycoside bactericidal activity is generally . A serum level of gentamicin is measured 6-14 hours after the first dose to determine the dosage interval. See Antimicrobial Guidelines (insert link) for alternative treatment or seek advice. From the tables below use the patients'height to give an estimate of ideal body weight and then select . Measure gentamicin level between 6 and 14 hr after initiating gentamicin infusion; use institution-specific nomogram to . MD = DW x QD-dose where QD-dose is: Amikacin, kanamycin = 15 mg/kg Gentamicin, Tobramycin, Netilmicin = 5 mg/kg Determine interval based on creatinine clearance Adjust dose Obtain a mid-interval drug level 6 to 16 hours after the initial dose, then evaluate the interval based on the dosage adjustment nomogram. The following criteria are used by this calculator to determine an aminoglycoside dosing weight: In underweight patients (less than ideal body weight), actual weight is used. Gentamicin Prescribing v8.1 Download. Doses at extremes of body-weight With intramuscular use or intravenous use The daily dose in newborns is 4-7mg/kg body weight per day.
It can also recalculate the dosage expressed in mg/kg into doses of liquid medication. Patients with a CrCl less than 20ml/min (refer to Guideline for Antibiotic Use in Patients with Renal Impairment) Patients under the care of the critical care team (refer to Critical Care Guidelines for Gentamicin) Patient with major burns (>20% of the total body surface) Patients with ascites. A baseline study demonstrated that dosing was only being carried out correctly 30% of the time. Calculate dosing weight (DW) DW = LBW + [ (ABW - LBW) x CF] where ABW = actual weight LBW = lean body weight CF = 40% correction factor for obesity 2. Safe pediatric dosages can be calculated from adult doses based on child's weight in kilograms.
The most commonly used dose is 80mg three times daily. be used to calculate the gentamicin dose 2. Formula to calculate Pediatric Dose based on mL administered Observed Trough/Peak - refers to the observed trough and peak levels obtained from blood work. Calculate . Target Trough/Peak - refers to the trough (pre) and peak (post) level desired. This calculator is based on the Sawchuk and Zaske's Equations. Initially 5-7 mg/kg once daily, subsequent doses adjusted according to serum-gentamicin concentration. The adult gentamicin and vancomycin calculators are intended for use only within NHS Greater Glasgow and Clyde and are available via the Clinical Info pages on StaffNet or the GGC Medicines app. Clinical . Preview. *Renal or cardiac dysfunction, use 2.5 mg/kg/dose IV q12-24 hours. Gentamicin calculator Gentamicin maintenance Creat Cl Dose 2.5 mg/kg (max 180 mg) then take a sample after 24 hours Age (years) Weight (kg) Height (cm) (inches) Ideal body weight (kg) Creatinine CL (ml/min) Gentamicin Initial Dosage Guidelines Creat Cl (ml/min) MONITORING OF GENTAMICIN CONCENTRATIONS An internet connection is required to access the calculator. In a trial by Del Priore et al, 7 patients with postpartum endometritis were randomized to gentamicin 5mg/kg once-daily or 1.75mg/kg 3 times daily, with both arms . The dosage calculator finds what dose of a medication is appropriate for your weight. Gentamicin (GGC) Dose Calculator for Adult Patients Intravenous Vancomycin Dose Calculator for Adult Patients Medical Scores & Calculators .
Use the online calculator to calculate an appropriate dose (maximum 450mg OD) Request daily Renal Profile (U+E's) whilst on Gentamicin Take a level 8-12 hours after the first dose; ensure the time the sample taken is clearly documented on the request (please check no other STAT doses have been administered in previous 24 hours) Prescribe initial dose on the gentamicin chart specifying the date and time the dose should be given. Record gentamicin dose and predicted frequency in the initial gentamicin dose box on the gentamicin PAM chart. Date Review 17.11.2023. This program will calculate the rate elimination constant (kel), the half-life and the volume of distribution from reported levels. Method of administration. GENTAMICIN GG&C DOSAGE REGIMEN Originally devised by Alison Thomson, Pharmacy Dept, Western Infirmary, Glasgow, 0141 211 2022 Developed by Stephen Dewar, Southern General Hospital, Glasgow 0141 2011396, March 2013 Version 1.1 NOTE: This is NOT a prescription chart. patients with high body weight).
Direct Oral Anticoagulants. 7. Gentamicin Pregnancy Dosing will sometimes glitch and take you a long time to try different solutions. Round dose to the nearest 10 mg increment. Conventional dosing: 2-2.5 mg/kg/dose every 8-12 hours; to ensure adequate peak concentrations early in therapy, higher initial dosages may be considered in selected patients when extracellular water is increased (edema, septic shock, postsurgical, or trauma) This has serious . Note: Ceftriaxone is rarely used in neonates. Gentamicin (GGC) dose calculator for adult patients. Maintenance dose starts 24h after loading dose.
Date Uploaded 17.11.2020.
Life-threatening infections: Initial dose: 5 mg/kg IM or IV infusion (over 30 to 120 minutes) per day, given in divided doses 3 to 4 times a day. The dose should be written as per chart and no time should be circled. If the online calculator is not used to calculate the dose, then ensure the calculations for the dose are documented in the space providedon the gentamicin prescribing chart. Please complete patient details below and file for reference. Gentamicin is an amino glycoside antibiotic, which is used predominantly in gram-negative infections but also has anti-staphylococcal activity. Calculate a 5mg/kg dose based on ideal body weight (NOT their actual weight) up to a maximum dose of 450mg. The actual dose and time should be written on the accompanying prescribing, administration and monitoring chart. Categories Clinical. Dose/Interval - Enter the dose of gentamicin (e.g. These blood levels are expressed as micrograms of gentamicin per milliliter of blood serum (mcg/ml), or milligrams of gentamicin per liter (mg/L these terms are equivalent). Pre-dose (trough) gentamicin levels should be checked after 24 hours of treatment (target <2mg/L) and peak levels measured one hour post-dose (target 5-10mg/L). LoginAsk is here to help you access Gentamicin Dosing Pregnancy Weight quickly and handle each specific case you encounter.
Gentamicin is normally administered intramuscularly but may be given intravenously as a slow intravenous injection over at least 3 minutes or short infusion if required . May increase to 50 mg/kg/dose 12 hourly or 80-100 mg/kg/dose 24 hourly. Gentamicin calculator (Hartford regimen) for adult patients. Read on to learn what the drug dosage calculation formula is and how to use it. Gentamicin: Time to steady state: 1 day (longer in renal impairment). Calculate creatinine clearance with the Cockcroft-Gault equation using an ideal body weight (IBW) or an adjusted body weight (ABW) if the patient is obese CrCL (mL/min) = (140 - age) x IBW ( x 0.85 for females ) SCr x 72 II. Based on the desired peak and trough the program will then generate a new regimen (dose and interval) to produce the desired levels. Calculate loading dose (LD) LD = (Cp Tmax x Vd x kel x tinf) / (1 - e -kel x tinf) where Cp Tmax = Target peak Vd = population volume of distribution (from 3i. In ONCE DAILY dosing, RANDOM levels should be obtained 8-12 hours AFTER THE START of infusion of the first dose. Systemic infections: 1 mg/kg IM or IV infusion (over 30 to 120 minutes) every 8 hours. Do not enter the unit. GUH IV Vancomycin Dose Calculator. Aminoglycosides distribute very poorly into adipose tissue; therefore, obese patients (actual body weight > 120% of IBW) require a correction in the weight used for Vdcalculation and dose. Gentamicin: Gentamicin - Guidance for Once Daily Intravenous Dosing in Adults; Gentamicin dose calculator (Adults) [intranet only] For use in Endocarditis in Adults - see Synergistic Gentamicin for Endocarditis in Adults [intranet only] For use in children - see Acute care - gentamicin and vancomycin for children/neonates; H I LoginAsk is here to help you access Gentamicin Pregnancy Dosing quickly and handle each specific case you encounter. of inches over 5 feet) For patients <5foot, use IBW = 45kg (women) or 50kg (men) 100 for 100mg) and dosing interval . IV Gentamicin dosing tool. Round the calculated dose to the nearest 10mg (e.g. Details provided below for background information.The calculator will not produce reliable results in patients who are anuric or in acute renal failure. : Comment: Dose depends on renal function (refer to Prescribing Step 1 in Gentamicin dosing guidelines).. Prescribe gentamicin 'as per chart' on the regular section . Creatinine CL (mL/min) CREATININE CLEARANCE CALCULATOR FOR ADULT . Using a specified dosing weight, you calculate a mg/kg dose
Doses at extremes of body-weight With intramuscular use or intravenous use Gentamicin Dosing Pregnancy Weight will sometimes glitch and take you a long time to try different solutions. Adult Gentamicin and Vancomycin Calculators. o Gentamicin: Dose at 4 to 7 mg/kg.
Temperature <36C or >38C 4 In labour a temperature of 37.5C on 2 separate occasions at least 2 hours apart Persistent tachycardia > 100bpm 5 Or >110bpm in labour Tachypnoea >20 breaths per minute 4 Or >22 in labour WCC <4 or >16 x 10 9 /L 4 Stick the gentamicin chart to the 'as required' page on the TPAR so the red band is clearly visible when TPAR closed. It is important to bear in mind that the formula tells us the dose of the medicine in the same interval of hours that is indicated. So sometimes we will have to verify if your dose is correct in a range of 24 hours. 3.2 Elderly/Renal (CrCl 10-29.9ml/min) Gentamicin Dosing Click here for quick reference guideline. The following criteria are used by this calculator to determine an aminoglycoside dosing weight: In underweight patients (less than ideal body weight), actual weight is used. Body Fluid Balance Calculator by Inputs and Outputs Calculates fluid balance from sodium concentrations which indicate net 0.9% saline, and free water losses (GI, urine, etc) and gains (IV fluids, PO, etc). Metric Imperial Aminoglycoside Dosing and Therapeutic Monitoring Conventional Aminoglycoside Dosing It is recommended to use "Extended Interval Dosing" (see below) if possible for optimal bactericidal activity, convenience, potentially reduced risk of nephrotoxicity and reduced cost for administration.
Give the recommended dose by infusion in 100ml sodium chloride 0.9% over 30 minutes. Due to the longer half-life, newborns are given the required daily dose in one single dose. How do I prescribe gentamicin on the cardex?
Gentamicin Protocol Which Dosing Regime Should I Use? If you are unable to access it from your mobile device please access the link to the calculator in the Useful Resources Folder on hospital desktops. below) It is important to note whether the dosage starts from the daily dose or the dose per administration.
1.4 Dosage adjustment in obese patients Obtain IBW from table 2 (gentamicin dosing table) OR use the following equation to calculate IBW IBW (kg) for males = 50 + (2.3 x no. Uncomplicated gonorrhoea [anogenital and pharyngeal infectionin combination with azithromycin] By intramuscular injection Child 16-17 years 240 mg for 1 dose.
Computerised methods can be successfully used for gentamicin monitoring. Adhere gentamicin chart to TPAR so that the red band is visible when TPAR closed. Figure 1. Child dose by weight = (mg/day) = Adult Dose in mg/kg or mg/kg/day x Child Weight in kg OR Dose: 50 mg/kg per dose 24 hourly. Gentamicin and vancomycin dosage calculators Gentamicin and vancomycin dosage calculators These calculators are available as part of the Healthcare Improvement Scotland / Scottish Antimicrobial Prescribing Group Antimicrobial Companion mega-app. Gentamicin and Tobramycin Dosing in Neonates. may require an increased dose to achieve higher peak levels. AMINOGLYCOSIDE DOSING STRATEGIES A. Gram negative infections 1. 36 Hour Gentamicin Calculator.
Paediatrics. Sampling time and target range: 6-14 hours after dose: see plot in Gentamicin dosing guidelines. Calculate . Dose = 5mg/kg x pregnancy booking weight (maximum dose 500mg) 4. Pseudomonas spp. GentamicinTobramycinAmikacin Dose mg Interval hrs Peak mcg/mL Time from start of infusion to peak ( 60 minutes) minutes Trough mcg/mL Time from start of infusion to trough hours Desired Peak mcg/mL Desired Trough mcg/mL Results for current dose V L K hr-1 Half-life hrs Cmax mcg/mL Cmin mcg/mL New/Alternative Dose Dose mg Interval hrs v If creatinine is not known - give an initial dose of 5 mg/kg gentamicin (maximum 400 mg) or, if Chronic Kidney Disease (CKD) 5, give 2.5 mg/kg (maximum 180 mg) on advice of senior staff.
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In obese patients, gentamicin dose should be calculated according to the corrected body weight (CBW) (7). It is commonly used because of its lack of diffogenicity. A copy of the Gentamicin calculator (Hartford Regimen) is available here. Use the online calculator to calculate an appropriate dose (maximum 450mg OD) Request daily Renal Profile (U+E's) whilst on Gentamicin Take a level 8-12 hours after the first dose; ensure the time the sample taken is clearly documented on the request (please check no other STAT doses have been administered in previous 24 hours) The first dose of directed therapy is based on the patient's age and weight, as for empirical therapy. Many of our babies are commenced on intravenous antibiotics for potential infection, following the implementation of a NICE guideline. Gentamicin should be prescribed in the parenteral section of the cardex. If creatinine clearance < 30mL/minute seek advice from pharmacy. Calculate the dose using actual body weight. Severe neonatal sepsis/meningitis caused by a gram negative agent with known sensitivities. Monitoring of blood levels is advisable, as absorption is increased by inflamed peritoneumPotential nephrotoxicity of the drug may worsen residual renal functionLong-term concurrent use of gentamicin with teicoplanin causes additive ototoxicity. Contraindications; Myasthenia Gravis : Gentamicin can impair neuromuscular transmission and must not be used in patients with Myasthenia Gravis. Pharmacokinetic Dosing by Levels - Aminoglycosides/ Vancomycin. This strategy would minimise risk of . Contains quick reference guide for dosing regimen single daily dosing renal impairement dosing renal dialysis dosing and multiple tranditional dosing; calculating doseage advice and monitoring levels. Advice should be sought from your ward pharmacist .
Williams Obstetrics remarks that once-daily gentamicin dosing in this circumstance is an "acceptable" alternative. Overview. In essence, you get an "aminoglycoside-free period" in the dosing interval.
Gentamicin Traditional Dosing: Adult gentamicin traditional dosing calculator is based on a calculation method proposed by Sarubbi and Hull. Table 1: Once Daily Gentamicin Dosing Guidelines Use the Gentamicin Dosing Calculator in the GAPP App to calculate Once Daily Gentamicin dose. They are CE marked and are currently undergoing review and upgrading. Uncomplicated gonorrhoea [anogenital and pharyngeal infectionin combination with azithromycin] By intramuscular injection Adult 240 mg for 1 dose. Prescribe in 'once only' section of medicine chart 6.
Document dose calculation on the gentamicin prescription chart and tick which source of first dose was used. The calculator would remove the need for multiple manual calculations required to ensure patients receive the correct dose of aminoglycoside antibiotics by calculating ideal body weight and adjusted body weight, the correct dosing calculation and frequency of dosing based upon the individualised patient parameters entered into the platform by the user. Monitoring of plasma concentrations is essential and should commence with this first dose of directed therapy to guide subsequent dosing. Overall, gentamicin is more active against Serratia marcescens. We experienced some difficulties in the administration of . of inches over 5 feet) IBW (kg) for females = 45.5 + (2.3 x no. Usual Adult Dose for Osteomyelitis. There are several validated nomograms available, but they generally operate on the same principles.
For all other patients, actual body weight (ABW) should be used to calculate the dose. It may be appropriate to check peak and trough levels in some patients (e.g. Reference. calculated: 347mg = actual dose: 350mg) Female . Download the app on the Apple store; Download the app on the Google Play store Gender. If the patient is started on either gentamicin or tobramycin and has a suspected Pseudomonas infection, pneumonia, osteomyelitis, meningitis, or sepsis, 7 mg/kg is used to calculate the initial dose.
Aminoglycosides weight-based dosing should be based on ideal or adjusted body weight. Calculation(s) used Calculation of Gentamicin dose Dose determining weight Ideal Body Weight is calculated from the patients height (using IBW calculation), this is compared with the patients actual body weight.If actual weight is > 20% of the IBW, then patient is classified as obese and the adjusted body weight is used as the dose-determining weight otherwise actual body weight is used. 5. Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved problems and equip you with a lot of relevant . If unable to access dosing calculators from your device or desktop, refer to the Aminoglycoside and . 4. Area Under The Curve (AUC): Ideal range is 80 - 100mg/L.hour Expected levels: Peak: >10mg/L Trough level at 24 hours post dose: < 2mg/L Trough level at 48 hours post dose: < 1mg/L Consult a senior physician if levels are outside This dosing regime should be used where the prescriber wishes to use an extended interval gentamicin dosing regime for the treatment of Gram negative sepsis in patients WITH severe renal impairment (Creatinine clearance <30mL/min- but discuss with There are recognised issues with its dosing of which time is a major factor.
DO NOT USE ONLINE GENTAMICIN CALCULATOR 2 Find out the pregnancy booking weight 3. These longer dosing intervals would allow the drug to washout, which then minimizes toxicity. In normal-weight patients (100-120% ideal weight), ideal body weight is used: 2. 1.
See Antibiotic Guidelines for advice on choices, and review recent Initial: 5-7 mg/kg/dose IV qDay. In normal-weight patients (100-120% ideal weight), ideal body weight is used: 2. The dose, given after dialysis, depends on the pre-dialysis level, the patient's estimated Vd, and the number of hours until the next dialysis session. Not for use in patients with ascites, burns covering >20% of total body surface area, cystic fibrosis, end-stage renal disease, endocarditis, infants, mycobacterial infections, or pregnancy.
CDDFT is made up of 2 medium sized district general hospitals; each with a paediatric unit and a special care baby unit. For all babies calculate "area under the curve" using the results obtained. When the gentamicin was infused, the blood level went up (peak level) and dropped over the next eight hours (trough level) as the gentamicin was excreted in the urine. Metric Imperial Dose accuracy should be to the nearest 20mg of gentamicin or use table 5. Administer dose in 100mls of 0.9% sodium chloride or 5% glucose over 1 hour .
The following prescribing resource has been produced to assist prescribers in the use of these agents for patients with AF and . Dose in adults Dose MUST be individualised according to renal function and weight Once-daily dosing for gentamicin is recommended for most patients, except in endocarditis, where lower, multiple daily dosing is used Once daily doses: The gentamicin dosing calculator on the GAPP app should be used to calculate the gentamicin dose. Duration of therapy: 7 to 10 days. o The random serum concentration obtained is then plotted on the Hartford nomogram to determine the appropriate dosing interval. Gentamicin Prescribing v8.1. File Size 258Kb.
In suspected cases of sepsis or enterococcal infection, ampicillin should be added to the regimen. Prescribe the initial dose of gentamicin in the prescription section of the chart. Downloads. Last updated on: 25th September 2017. Do not continue to use this online tool, all ongoing options have now been . Gentamicin Calculator (Hartford Nomogram) Downloadable Gentamicin calculator. The 7 mg/kg dose uses the .
Dose calculation Obtain information on: Sex Weight (kg) Height Serum creatinine (micromol/L) to check renal function. Dose varies according to local protocol and whether CAPD : or APD dialysis. IBW and Gentamicin Calculator. Reference range: Once Daily Pre dose <1 mg/L and Post dose >10 mg/L or 8 hour post (4.5 mg/kg) 1.5-6 mg/L or follow Hartford nomogram (but note this is for 7mg/kg) Once Daily 5 mg/kg Pre dose <2 mg/L but <1 mg/L after 3rd dose and post dose >8 mg/L BD or TDS Gm - pneumonia Pre dose <2 mg/L Post dose >7 mg/L Infective endocarditis (IE) 6. The dose calculator tool is intended to help in calculating initial Gentamicin doses when creatine clearance can only be estimated. Use the charts below for dosing of Gentamicin and Tobramycin ONLY: *Use interval of q 36 hours for infants with HIE or significant asphyxia. Age under 65 years 5mg/kg* iv od 3mg/kg* iv od Do not give gentamicin Round dose up or down to the nearest 20mg Minimum doses - If after dose re-calculation the revised dose is less than 2mg/kg, strongly consider alternative gram negative cover. Does this patient have any contraindications to Gentamicin use?
Intermittent Hemodialysis Calculator: The key to this calculator is to target a pre-dialysis level of about 20 mcg/ml because this will give a daily AUC of about 500. Gentamicin is widely used, but resistance is an issue. Initially 5-7 mg/kg once daily, subsequent doses adjusted according to serum-gentamicin concentration.
Interactions Risk of ototoxicity and nephrotoxicity is increased with concurrent use of vancomycin, 3 Calculate a Dose Based on Ideal Body Weight (IBW) Use the attached table to obtain your patient's ideal body weight (IBW). Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved problems and equip . Which is correct, because Gentamicin has a dose of 5-7.5 mg / Kg / day. There are various other single dose calculators on the net and for various reasons they will give different recommendations. Some infections, such as. The dose amount and dosage interval are based on estimated creatinine clearance (Box 1) and actual body weight.
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