For the selected aminoglycoside, administer a loading dose to provide peak serum levels.
loading dose in mg/kg
expected peak serum levels, in µg/mL
Amikacin
5.0 - 7.5
15 - 30
Gentamicin
1.5 - 2.0
4 - 10
Netilimicin
1.5 - 2.0
4 - 10
Tobramycin
1.5 - 2.0
4 - 10
loading dose =
= (loading dose in mg/kg) * (body weight in kilograms)
The Ideal Body Weight is recommended for calculating the loading dose, rather than the actual weight, because of the low therapeutic index for the aminoglycosides. For obese patients, a body weight between the ideal and actual body weight is used.
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