Amikacin
CrCl
(ml/min)
>60
40-59
30-39
Intermittent HD
CRRT
CAPD
Amikacin
Not recommended
15 mg/kg q 48 h
15 mg/kg q 36 h
15-20 mg/kg q 24 h
Not recommended
??
<30
Not recommended
Contraindications for High-Dose Extended-Interval Dosing: Pregnancy, Burn > 20%BSA, Large ascites, endocarditis (Please use conventional dosing.)
Conditions | Dose |
|---|---|
CrCl > 60 ml/min | 15 - 20 mg/kg q24h |
CrCl 40 - 59 ml/min | 15 mg/kg q36h |
CrCl 30 - 39 ml/min | 15 mg/kg q48h |
CrCl 20 - 30 ml/min | Not recommended |
CrCl < 20 ml/min | Not recommended |
Hemodialysis | Not recommended |
CAPD (peritonitis) | 2 mg/kg IP once daily |
CRRT | CVVH, CVVHDF 25 mg/kg q48h |
SLED | No data |
Contraindications for High-Dose Extended-Interval Dosing: Pregnancy, Burn > 20%BSA, Large ascites, endocarditis (Please use conventional dosing.)
Conditions | Dose |
|---|---|
CrCl > 60 ml/min | 10 - 15 mg/kg q24h |
CrCl 40 - 59 ml/min | 10 - 15 mg/kg q24-48h |
CrCl 30 - 39 ml/min | 10 -15 mg/kg q48-72h |
CrCl 20 - 29 ml/min | Dose by level |
CrCl < 20 ml/min | Dose by level |
Hemodialysis | Dose by level |
CAPD | Dose by level |
CRRT | Dose by level |
SLED | No data |
Alternative Thrice weekly(CrCl>40): 10 - 25 mg/kg TIW , age > 50 year 10 mg/kg TIW, max single dose of 500 mg
Conditions | Dose |
|---|---|
CrCl > 60 ml/min | 5 - 7.5 mg/kg q8h |
CrCl 40 - 59 ml/min | 5 - 7.5mg/kg q12h |
CrCl 30 - 39 ml/min | 5 - 7.5 mg/kg q24h |
CrCl 20 - 29 ml/min | 5 - 7.5 mg/kg q24h |
CrCl < 20 ml/min | 5 mg/kg once then dose by level |
Hemodialysis | 5 - 7.5 mg/kg post dialysis |
CAPD (peritonitis) | 2 mg/kg IP once daily |
CRRT | 10 mg/kg loading dose then 7.5 mg/kg q24-48h |
SLED | No data |
The Cockcroft-Gault equation may yield inaccurate estimates based on a patient's body weight and BMI. By including additional height information, we can calculate BMI and provide a modified estimate and range.
- Underweight: For a BMI of 18.5 or less, use the actual body weight for calculations.
- Normal Weight: Use the ideal body weight for calculations.
- Overweight/Obese: For a BMI of 25 or higher, use the adjusted body weight for calculations.
Calculation Steps
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