the continued suppression of bacterial growth when antibiotic lefvels are below the MIC of the organism.

(1) Gentamicin

(2) Tobramycin

(3) Amikacin

AMGs are:

(a)  mainly active against what?

(b) used in synergy for treating what?

(1) Which one has a special formulation for cystic fibrosis (CF)?

(2) which has the boradesta activity?

(3) describe typical dosing?

(1) gram negative bacteria (e.g. pseudomonas)

(2) gram positive cocci (e.e. enterococcus endocarditis)

(3)Tobramycin comes in an inhaled formulation (TOBI) used in CF with PARI-LC PLUS nebulizer

(4) Amikacin

(5) Dose on IBW. Use ABW for obese bitches.

D

Gent/Tobra:     1-2 mg/kg/dose

Amikacin:         5-7.5 mg/kg/dose

Note: take trough level right before next dose, take peak level 1/2 hour after the end of drug infusion.

Note: those not in renal failure receive it every 8hrs. As renal function declines, the frequency of administration declines (8hrs to 12hrs &c.)

Gent/tobra:     4-7 mg/kg

Amikacin:        15-20 mg/kg

Note: draw random level within 8-12 hrs post dose; determine frequency based on nomogram.

Note: extended interval dosing is less nephrotoxic and more cost-effective.

                                       Peak (mcg/mL)          Trough (mcg/mL)

Gent:                5-10                  <2

Tobr:                5-10                  <2

Amik:               20-30               <5

Cockcroft Gault Formula

Estimated CrCl = [(140-age)(wt in kg]/(72 x SCr)

multiply by 0.85 if female

Males: BW = 50kg + (2.3kg x height in inces > 60)

Females: BW = 45.5kg + (2.3kg x height in inches > 60)

Adjusted Body Weight (ABW):

ABW (kg) = IBW + [0.4 (TBW - IBW)]