Interpretation of Aminoglycoside Interval level - Hartford nomogram
Plot aminoglycoside concentration on following nomogram (Hartford Nomogram: Antimicrob Agents Chemother 1995; 39(3): 650-5):
This nomogram applies only with doses of 7mg/kg. If other dose used - consult pharmacist.
This nomogram assumes volume of distribution (Vd) of 0.3 L/kg. If patient's estimated Vd different, consult pharmacist.
For amikacin, divide measured serum level by 2 and plot on the nomogram
If the interval level falls in the areas marked as q24h, q36h, or q48h, the dosing interval should be every 24, 36, 48h respectively
If the interval level falls on one of the sloping lines, choose the longer interval
If above the q48h dosing interval area, DISCONTINUE extended interval dosing and switch to conventional dosing of aminoglycosides (See Conventional Aminoglycoside Dosing Guidelines or consult pharmacist.)
If below the nomogram (i.e. < 2 mg/L), aminoglycoside dosing/therapy should be reassessed if patient not improving. A pharmacist consult is suggested.
