Pharmacology
Extended-Interval Aminoglycoside Dosing (Hartford Nomogram)
Calculates once-daily Gentamicin, Tobramycin (7 mg/kg), and Amikacin dosing and interval selection.
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Parameters
Extended-Interval Aminoglycoside Dosing (Hartford Nomogram) Result
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Formula
Dose (mg) = Dosing Weight (IBW / AdjBW) × 7 mg/kg (Gentamicin/Tobramycin) or 15 mg/kg (Amikacin)
Interval is determined by single random 6-14h post-dose level plotted on the Hartford Nomogram.Clinical Pearls
Capitalizes on the post-antibiotic effect (PAE) and concentration-dependent killing of Gram-negative pathogens (e.g. Pseudomonas) while drastically reducing renal accumulation.
Limitations
Not validated for synergistic enterococcal endocarditis (requires traditional low-dose 1 mg/kg TID dosing) or in end-stage renal disease / dialysis.