Hi,
We do the usual dose of an aminoglycoside as well since you do have to load the 
patient. If treatment continues then we do dose adjustments going forward.

Martha J. Roberts, Pharm.D.
Lead Clinical Pharmacist/Critical Care Specialist
St. Joseph Health Services of RI
200 High Services Avenue
No. Providence, RI 02904
(401) 456-3382

From: [email protected] 
[mailto:[email protected]] On Behalf Of Yash Javeri
Sent: Wednesday, September 18, 2013 5:27 AM
To: Harkey,Jessica
Cc: [email protected]
Subject: Re: [Sepsis Groups] Aminoglycoside dosing in severe sepsis/septic shock

The dictum in antibiotic prescription is no change in loading dose of 
antibiotic with any co morbidity

On 17-Sep-2013, at 22:57, "Harkey,Jessica" 
<[email protected]<mailto:[email protected]>> wrote:
Hello there. I have been having some discussion with our pharmacists on whether 
or not patients who present to the ED in severe sepsis or septic shock should 
receive a full dose of an aminoglycoside (when indicated) within the first hour 
regardless of Cr clearance? The practice of our ED physicians thus far has been 
to order a full dose, and now we are getting some feedback from pharmacy to 
reduce the dose per renal function, which seems appropriate with consecutive 
doses along with monitoring drug levels. I am concerned about delaying 
administration.  For initial empric therapy what are the rest of you doing in 
such cases? Any literature available for me to share with the pharmacy?
Thank you!

Jessica Harkey, RN, BSN, CCRN
Sepsis Program Coordinator
San Joaquin Community Hospital
661-869-6874
[email protected]<mailto:[email protected]>
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