Aminoglycoside Dosing
Patient demographics
Calculated weights
Renal function
CrCl: — mL/min
Dosing weight: — kg
Hold — AKI trigger
Known AKI is ON — the Empiric method switches to HCA dose-by-level (a single dose, then re-dose only on a measured level).
Low muscle mass / cachexia
No lab value encodes these — serum creatinine reflects muscle-derived production as well as clearance.
Low muscle mass — creatinine-based CrCl likely OVERESTIMATES true GFR
Switching creatinine equations does not fix this (CKD-EPI can be worse). Draw levels from the FIRST dose and dose from measured PK; consider cystatin C (eGFRcr-cys, KDIGO 2024) for the interval.
Regimen & target
Institutional standard: 30 minutes. Materially changes the peak.
With an MIC entered the peak target is re-anchored to 8–10 × MIC (HCA 2023; Moore-Lietman 1987).
Empiric options
Leave blank to use the guideline mg/kg for this drug, indication and method.
Current regimen
Infusion duration is required — it materially changes the back-extrapolated true peak.
MWF = 48/48/72 h. A single interval uses the 48 h gap (peak- & accumulation-limiting). For the exact 48/48/72 schedule, use the MWF course table.
Measured levels
NTM (amikacin): this runs a single-level assessment — regimen-aware target, back-extrapolated true peak, peak:MIC, and a cumulative-dose toxicity check. Enter the dose, infusion duration, and the measured post-infusion level with its draw time.
Level 1 — 2–4 h after the end of infusion
Level 2 — 10–14 h after the end of infusion
Previous dose — the one before these levels
A two-level fit models ONE dose. Telling it what came before lets it say how much of each level is leftover drug, and send you to the Course tab when that matters.
Level
Therapeutic target
Auto-filled from the indication — edit to override before calculating.
Bayesian precision fit
Fits this patient's own clearance (CL) and volume of distribution (Vd) to the level(s) below by maximum a posteriori (MAP). Uses the Patient, Renal and Regimen blocks above.
MWF = 48/48/72 h. A single tau uses the 48 h gap (peak- & accumulation-limiting). For the exact 48/48/72 schedule, use the MWF course table.
Measured levels
Doses — dated schedule
Every dose start, amount, and infusion duration. Irregular intervals (e.g. MWF) are fine — the fit superposes each dose over the full schedule.
Levels — dated draws
Each measured level with its draw time. Enter at least two informative levels to fit both Ke and Vd; a single level is under-determined (Vd is held at the population prior).
Uses the Patient, Renal and Regimen blocks above, plus the Current regimen & Target from the “Adjust from levels” tab. If the Current regimen is blank, it infers the dose/infusion from the most recent dose row and the interval from the modal dose spacing.
Saved profiles
De-identified, stored in this browser only (localStorage) — do not enter PHI.
Results
PK parameters
Enter age, sex, height, weight and SCr to derive the PK parameters.
Recommendation
Enter the patient, drug and indication, then press Calculate.
AKI — dose by level (no fixed interval)
Try an alternative dose & interval
Full reasoning trace
Recommendation
Enter the current regimen, at least one level (peak / trough / true peak), and the target, then press Calculate.
Full reasoning trace
Recommendation
Current regimen — what the levels were drawn on
No dose is computed for this result — see the full reasoning below.
Bayesian fit (individual CL/Vd)
- Clearance (CL)
- Volume (Vd)
- Ke / half-life
- AUC24 (steady state)
- Cmax/MIC · AUC24/MIC
The concentration-time curve needs a periodic dosing interval.
Full reasoning trace
Recommendation
Enter the dated doses and at least two dated levels, then press Calculate.
Predicted vs observed levels
| Time (h) | Observed | Predicted | Δ |
|---|
Full reasoning trace
Concentration-time curve