Pulse Dosing of Aminoglycosides & Vancomycin Dosing For Adults

Marshall Pierce, PharmD

Pulse dosing levels may be after the first dose. Vancomycin levels should be at steady State.

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Use the tab key to navigate the form. Required data entry fields are teal in color.

Enter Age (years)
Enter Height in
Enter Actual Weight in
Select Sex
Enter Most Recent Serum Creatinine (mg/dl)
Enter Previous Serum Creatinine (mg/dl) Use the same value twice if renal function is stable.
Enter time between serum creatinines (hours). Use 24 if renal function is stable. Creatinines should be > 1 T1/2 apart to accurately determine creatinine clearance when renal function is changing.
Select Drug
Enter Infusion Period (hours): Aminoglycosides (0.5-1 hours) Vancomycin 2 hours (1000 mg/hour)

Calculated Ideal Body Weight (kg)
Calculated Drug Dosing Weight (kg)
Body Surface Area (Meters Squared) DuBois & DuBois Formula
Calculated Weight Used In Creatinine Clearance Calculation
Calculated Creatinine Clearance (ml/min) Cockcroft-Gault Equation
Calculated T1/2 for CREATININE (hours)
Calculated Drug K (hours-1)
Calculated Drug T1/2 (hours)
Calculated Drug Vd (liters)
Calculated Maintenance Dose (mg) Gentamicin/Tobramycin Pulse 5 mg/kg * Dosing Weight Amikacin Pulse 15 mg/kg * Dosing Weight Vancomycin 15 mg/kg * Actual Weight
Enter Rounded Maintenance Dose (mg)
Calculated Dosing Interval (hours)
Enter Dosage Interval (hours)

Calculated Peak (mcg/ml) Normal for Pulse Dosing Amikacin ~ 50-60 mcg/ml Gentamicin/Tobramycin ~ 18-20 mcg/ml Maximum for Traditional Dosing : Amikacin ~30 mcg/ml Gentamicin/Tobramycin 10 mcg/ml Pneumonia 8-10 mcg/ml Sepsis 6-8 mcg/ml UTI 4-5 mcg/ml Endocarditis 4-5 mcg/ml
Calculated Trough (mcg/ml) Maximum for Pulse Dosing: Amikacin 1 mcg/ml Gentamicin/Tobramycin 0.3 mcg/ml for 5 mg/kg Pulse Dose Gentamicin/Tobramycin 0.5 mcg/ml for 7 mg/kg Pulse Dose
Time (hours) to 87.5% of Steady State from first dose (assuming no loading dose)
Area Under the Curve mgh/L per day Amikacin: Pulse Dosing 15 mg/kg of dosing weight Maximum AUC 353 mgh/L per day Gentamicin/Tobramycin: Pulse Dosing 5 mg/kg of dosing weight Maximum AUC 117 mgh/L per day Pulse Dosing 7 mg/kg of dosing weight Maximum AUC 165 mgh/L per day Vancomycin AUC of 400-600 mg*h/L Monitor AUC for vancomycin with a peak and trough after the same dose and use the peak and trough dosing calculator as the accuracy of the AUC calculation is improved.
Please complete the input boxes below if you have an actual level and the time is was drawn. These values along with the entered dose and frequency will be used to calculated the patient's elimination rate constant (K).
Enter Actual Measured Level mcg/ml Pulse Dose Levels are recommended to be drawn 14.5 hours from the start of the previous dose and may be after the first dose. True troughs should not be used with pulse dosing. Vancomycin levels should be steady state levels.
Enter Time Level Drawn FROM START OF PREVIOUS DOSE (hours)

K (hours-1) Fit (Fit from level, time of level, and entered dose and frequency.)
Thanks for using the program. If you have any comments, suggestions or questions please contact the author.

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