Nephrology · Clinical Calculator · Antimicrobial Dosing

Aminoglycoside Dose & Interval by CrCl · Extended-Interval & Conventional

Compute gentamicin, tobramycin, or amikacin dose and dosing interval from Cockcroft-Gault creatinine clearance. Choose extended-interval (once-daily, Hartford-style) or conventional multiple-daily dosing; enter height to use Devine ideal/adjusted body weight in obesity. For systemic infection only — not synergy/endocarditis dosing — and never a substitute for therapeutic drug monitoring.

Published: References: 3 Read time:

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Instructions
  1. Select the drug group: gentamicin/tobramycin (7 mg/kg extended-interval) or amikacin (15 mg/kg extended-interval).
  2. Choose the dosing strategy: extended-interval (once-daily, Hartford-style) or conventional multiple-daily dosing.
  3. Select the weight, creatinine, and height units to match your records. Switching a unit clears that field.
  4. Enter age, sex, and the actual body weight; enter the steady-state serum creatinine (not during AKI).
  5. Enter height (optional) to compute Devine ideal body weight (IBW) and adjusted body weight — the tool automatically uses the adjusted weight when the patient is obese (actual > 1.2 × IBW), and the lower (actual vs adjusted) otherwise.
  6. The result shows the Cockcroft-Gault CrCl, the dosing weight used, the recommended mg dose (rounded), and the recommended interval — with monitoring guidance.

All computation runs in your browser; no values are stored or transmitted. This is a starting regimen only — verify against your formulary and mandatory therapeutic drug monitoring.

When to Use

Use this tool to select an initial aminoglycoside regimen — drug dose (mg) and dosing interval — for an adult being treated for a systemic gram-negative infection. The interval is driven by Cockcroft-Gault creatinine clearance, the same equation on which the Hartford extended-interval (once-daily) nomogram and conventional renal-dosing tables were built. Two strategies are supported: extended-interval (high once-daily dose exploiting concentration-dependent killing and the post-antibiotic effect, with prolonged drug-free troughs to limit accumulation/nephrotoxicity) and conventional multiple-daily dosing (lower per-dose, more frequent administration) when extended-interval is inappropriate.

Appropriate population

Adults (≥18 years) with stable renal function being treated for a serious gram-negative infection where empiric aminoglycoside therapy is indicated. Extended-interval dosing is the default for most such patients; conventional dosing is used when extended-interval is contraindicated. Enter height to enable Devine ideal/adjusted body weight, which the tool uses automatically in obesity.

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When NOT to use it

Do not use this tool for synergy (gram-positive) dosing — endocarditis and enterococcal synergy use much lower doses (e.g. gentamicin 1 mg/kg q8h targeting peaks ~3–4 mg/L), not the regimens here. Avoid extended-interval dosing in pregnancy, extensive burns, ascites/major fluid shifts, CrCl < 20 mL/min, dialysis, and when synergy dosing is intended — use conventional, level-guided dosing instead. The estimate assumes steady-state creatinine; it is unreliable in AKI or rapidly changing renal function. This calculator never replaces mandatory therapeutic drug monitoring.

Pearls & Pitfalls
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Dose by the right weight, then monitor levels

Aminoglycosides distribute mainly in lean tissue, so in obesity dose on adjusted body weight (IBW + 0.4 × [actual − IBW]) rather than actual weight — using actual weight overdoses these patients. This tool applies adjusted weight automatically when actual > 1.2 × IBW. After the first dose, the regimen is confirmed by therapeutic drug monitoring, not by the nomogram alone.

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Hartford monitoring for extended-interval

For once-daily (7 mg/kg gentamicin/tobramycin) dosing, draw a single random level 6–14 hours after the first dose and plot it on the Hartford nomogram to confirm or lengthen the interval (q24h / q36h / q48h). The pre-dose trough should be undetectable (< 1 mg/L) — a measurable trough means the interval is too short or clearance has fallen. Amikacin uses the same principle at 15 mg/kg.

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Pitfalls

(1) Not for synergy/endocarditis dosing — those use far lower q8h regimens. (2) Do not use fixed extended-interval dosing at CrCl < 20 mL/min, in dialysis, pregnancy, burns, or major fluid shifts — switch to conventional, level-guided redosing. (3) The CrCl estimate is invalid in AKI or rapidly changing renal function. (4) Nephrotoxicity and ototoxicity (often irreversible) rise with duration — keep courses as short as possible and avoid concomitant nephrotoxins. (5) Always confirm dose, interval, and targets against your formulary and TDM service.

Why Use It

Aminoglycosides kill in a concentration-dependent manner and exert a prolonged post-antibiotic effect, so a single high daily dose maximizes the peak-to-MIC ratio (efficacy) while the long drug-free interval allows renal washout that limits the saturable proximal-tubular uptake driving nephrotoxicity. Extended-interval dosing therefore tends to be at least as effective as conventional dosing with comparable or lower toxicity, and it simplifies monitoring to a single nomogram level. Because the therapeutic window is narrow and toxicity is dose- and duration-dependent, getting the initial dose and interval right — adjusted for renal function and the correct dosing weight — protects patients from both treatment failure and avoidable nephro-/ototoxicity. Mandatory drug-level monitoring then individualizes the regimen.

Aminoglycoside Dose & Interval Calculator (by CrCl)

Select the drug and dosing strategy, then enter age, sex, weight, and serum creatinine. The tool computes Cockcroft-Gault CrCl, picks the dosing weight (adjusted body weight in obesity), and returns a recommended mg dose and interval for extended-interval or conventional dosing.

Weight unit:
Creatinine unit:
Height unit:
Gentamicin/tobramycin 7 mg/kg · amikacin 15 mg/kg (extended-interval)
Extended-interval is preferred for most systemic infections
Adults (≥18 yr)
Female applies a 0.85 CrCl correction
Actual measured weight. Adjusted weight is used automatically in obesity.
Normal: 0.7–1.3 mg/dL. Use steady-state creatinine, not during AKI.
Optional — enables Devine IBW and adjusted body weight for obese patients.
Creatinine Clearance
mL/min (Cockcroft-Gault)
Dosing Weight
Recommended Dose
Recommended Interval

⚕ CrCl by Cockcroft-Gault: [(140 − age) × weight(kg) × (0.85 if female)] / (72 × SCr mg/dL). Dosing weight = adjusted BW (IBW + 0.4×[actual − IBW]) when actual > 1.2 × IBW, else the lower of actual vs adjusted (actual if no height). Extended-interval: gentamicin/tobramycin 7 mg/kg, amikacin 15 mg/kg; interval q24h (CrCl ≥60) / q36h (40–59) / q48h (20–39); CrCl <20 → use conventional level-guided dosing. Conventional: gentamicin/tobramycin ~1.7 mg/kg, amikacin 7.5 mg/kg; interval q8h / q12h / q24h / q48h by CrCl. A starting regimen only — mandatory therapeutic drug monitoring required. Not for synergy/endocarditis dosing. Source: Nicolau DP et al. Antimicrob Agents Chemother. 1995;39(3):650–655 (Hartford nomogram).

Next Steps

Use the result as a starting regimen — then individualize with drug levels.

  • Give the calculated dose, then obtain therapeutic drug monitoring: for extended-interval, a single random level 6–14 h after the first dose plotted on the Hartford nomogram; for conventional dosing, a peak and trough around the third dose.
  • Target levels — gentamicin/tobramycin: conventional peak 5–10 mg/L, trough < 2 mg/L; amikacin: peak 20–30 mg/L, trough < 10 mg/L. Extended-interval troughs should be undetectable (< 1 mg/L).
  • Recheck renal function and creatinine at least every 2–3 days (daily if unstable); recompute the regimen if creatinine changes.
  • Keep the course as short as clinically appropriate; reassess the need for the aminoglycoside daily and de-escalate once cultures allow.
  • Involve clinical pharmacy / nephrology for CrCl < 20 mL/min, dialysis, rising creatinine, hearing/vestibular symptoms, or pregnancy/burns/major fluid shifts.
Evidence & References

Formula & Equations

QuantityEquation
Creatinine clearance (mL/min)[(140 − age) × weight in kg × (0.85 if female)] ÷ (72 × SCr in mg/dL)
Ideal body weight — men (Devine)50 + 2.3 × (height in inches − 60)
Ideal body weight — women (Devine)45.5 + 2.3 × (height in inches − 60)
Adjusted body weightIBW + 0.4 × (actual weight − IBW)
Dosing weight ruleAdjusted BW when actual > 1.2 × IBW (obesity); otherwise the lower of actual vs adjusted (actual when no height given)
SI conversionSCr (mg/dL) = SCr (µmol/L) ÷ 88.4; weight (kg) = lb ÷ 2.2046; height (in) = cm ÷ 2.54

Extended-interval (once-daily) dosing

CrCl (mL/min)IntervalDose (of dosing weight)
≥ 60q24hGentamicin / tobramycin 7 mg/kg · Amikacin 15 mg/kg
40–59q36h
20–39q48h
< 20Do NOT use fixed extended-interval — switch to conventional, level-guided redosing

Conventional (multiple-daily) dosing

CrCl (mL/min)IntervalDose per dose (of dosing weight)
≥ 60q8hGentamicin / tobramycin ~1.7 mg/kg (1.5–2) · Amikacin 7.5 mg/kg
40–59q12h
20–39q24h
< 20q48h or by levels

Target levels

Drug / regimenPeakTrough
Gentamicin / tobramycin — conventional5–10 mg/L< 2 mg/L
Amikacin — conventional20–30 mg/L< 10 mg/L
Extended-interval (any agent)Random level on Hartford nomogram (6–14 h post-dose)Undetectable (< 1 mg/L)

Doses are rounded to a practical increment (nearest 10–20 mg) and are a starting point only. Confirm against local protocols and adjust to measured drug levels. These regimens are not for synergy/endocarditis dosing, which uses lower doses (e.g. gentamicin 1 mg/kg q8h). KDIGO highlights aminoglycosides as an avoidable cause of nephrotoxic AKI — use the shortest effective course and avoid concomitant nephrotoxins.

Evidence & References

Extended-interval aminoglycoside dosing exploits concentration-dependent killing and the post-antibiotic effect; the Hartford program (Nicolau 1995) standardized a 7 mg/kg once-daily gentamicin/tobramycin regimen with a single nomogram level, achieving efficacy comparable to conventional dosing with low nephrotoxicity. CrCl is estimated by Cockcroft-Gault (1976) and dosing weight by the Devine ideal/adjusted body-weight method (1974). KDIGO cautions that aminoglycosides are a leading reversible/avoidable nephrotoxic insult.

  1. Nicolau DP, Freeman CD, Belliveau PP, Nightingale CH, Ross JW, Quintiliani R. Experience with a once-daily aminoglycoside program administered to 2,184 adult patients. Antimicrob Agents Chemother. 1995;39(3):650–655.
  2. Cockcroft DW, Gault MH. Prediction of Creatinine Clearance from Serum Creatinine. Nephron. 1976;16(1):31–41.
  3. Devine BJ. Gentamicin Therapy. Drug Intell Clin Pharm. 1974;8(11):650–655.
  4. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117–S314.
Important: This calculator is an educational aid for licensed clinicians and does not replace individualized assessment, current prescribing information, or therapeutic drug monitoring. It produces a starting aminoglycoside regimen only; mandatory drug-level monitoring must individualize subsequent dosing. It is not for synergy/endocarditis dosing, and the underlying CrCl estimate is invalid in acute kidney injury. Verify every dose, interval, and target level against your formulary and TDM service before prescribing.

Use this with

References 3 sources
  1. KDIGO 2024 CKD Guidelines
  2. ACC/AHA 2026 Dyslipidemia
  3. ADA Standards of Care 2025
Dr. W Rivero, MD

W Rivero, MD, FPCP, DPSN

Specialist in Internal Medicine, Nephrology, and Clinical Nutrition. Practicing integrative and evidence-based nephrology across Quezon City, Pampanga, and Bulacan.

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