A 60-year-old man with septic shock is commenced on a gentamicin infusion for suspected Gram-negative sepsis. He weighs 80 kg. His creatinine is 180 µ...

Question

A 60-year-old man with septic shock is commenced on a gentamicin infusion for suspected Gram-negative sepsis. He weighs 80 kg. His creatinine is 180 µmol/L (eGFR 35 mL/min). A trough gentamicin level taken before the second dose returns at 2.8 mg/L (target

Accepted Answer

Withhold gentamicin until the trough level falls below 1 mg/L, then extend the dosing interval

Answer

Continue the current dose and recheck trough before the third dose

Answer

Reduce the dose by 50% and administer at the same interval

Answer

Switch to IV amikacin as it is less nephrotoxic

Answer

Administer the next dose immediately as therapeutic levels are needed urgently

uk-fficm MCQ (SBA): Therapeutic Drug Monitoring