Pharmacology

Extended-Interval Aminoglycoside Dosing (Hartford Nomogram)

Calculates once-daily Gentamicin, Tobramycin (7 mg/kg), and Amikacin dosing and interval selection.

Parameters

Extended-Interval Aminoglycoside Dosing (Hartford Nomogram) Result

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FormulaDose (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.