The Hull and Sarubbi Nomogram

  1. Select loading dose in mg/kg (LBW).

    AMINOGLYCOSIDE USUAL LOADING DOSES EXPECTED PEAK LEVEL
    Tobramycin / Gentamicin 1.5 to 2 mg/kg 4 to 10 mcg/ml
    Amikacin / Kanamycin 5 to 7.5 mg/kg 15 to 30 mcg/ml

  2. Select maintenance dose (as percentage of loading dose).


    		Interval
    CrCl
    (ml/min)         		Half-Life
    (hrs)         		8 hrs 12 hrs 24 hrs
    90 3.1 84% -- --
    80 3.4 80 91% --
    70 3.9 76 88 --
    60 4.5 71 84 --
    50 5.3 65 79 --
    40 6.5 57 72 92%
    30 8.4 48 63 86
    25 9.9 43 57 81
    20 11.9 37 50 75
    17 13.6 33 46 70
    15 15.1 31 42 67
    12 17.9 27 37 61
    10 20.4 24 34 56
    7 25.9 19 28 47
    5 31.5 16 23 41
    2 46.8 11 16 30
    0 63.9 8 11 21

Reference:
Sarubbi FA, Hull JW. Gentamicin serum concentrations: pharmacokinetic predicitions. Ann Intern Med 1976;85:183-189.

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