Is there a maximum recommended daily dose?

As you have learned, a once-daily dose of aminoglycosides is often used due to their concentration-dependent action and the PAE. In addition, some studies suggest that this dosing approach is associated with lower toxicity.

We provided dosage calculations for gentamicin based on kidney function and weight and explained how pathophysiological changes in sepsis can result in a lower Cmax and potentially lower efficacy, resulting in higher dosage requirements. However, as you learnt in week 1, aminoglycosides can have significant adverse effects and their toxicity is linked to levels in the body.

So, when considering all of the variables that influence the dose alongside the potential for serious adverse effects, is there a maximum recommended dose of aminoglycosides?

Yes!

However, the maximum recommended doses may differ between healthcare facilities.

When considering gentamicin specifically, some local recommendations suggest a maximum dose of 560mg.

Adjusting for weight, it is unlikely that dosing based on ABW in the non-obese or DDW in the obese would calculate a dose greater than this. Therefore, it is recommended to seek expert advice if the dose calculated is greater than 500mg.

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Think about the question below, and discuss your answer with other learners in the comments section.

• Are you aware of a maximum recommended dose for aminoglycosides where you work?

Once you’ve left your comment, click next to learn about dosing in sepsis.