What is the clinical basis for extended-interval aminoglycoside dosing?

Aminoglycosides exhibit concentration-dependent bactericidal activity and post-antibiotic effect. High Cmax/MIC ratio (10:1) maximizes killing. Once-daily dosing achieves higher peak concentrations (optimizing kill) while allowing trough levels to approach zero (minimizing nephrotoxicity and ototoxicity).

When is extended-interval aminoglycoside dosing contraindicated?

EID is not appropriate for: enterococcal endocarditis (requires synergistic dosing), pregnancy (altered pharmacokinetics, safety data limited), burns >20% BSA, CF (altered Vd), severe ascites, CrCl <20 mL/min, and neonates. Synergistic (low-dose) dosing is preferred for viridans streptococcal endocarditis.

Aminoglycoside Extended Interval Dosing Calculator

Calculate gentamicin or tobramycin extended-interval (once-daily) dose using weight-based dosing (5–7 mg/kg) with Hartford nomogram for subsequent dose interval adjustment.

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Frequently Asked Questions

What is the clinical basis for extended-interval aminoglycoside dosing?

When is extended-interval aminoglycoside dosing contraindicated?