pathologyhandbook
Royal Berkshire NHS Foundation Trust
Antibiotic Assay: Gentamicin - Please refer to the Adult IV Gentamicin guideline
Antibiotic Assay: Vancomycin, Tobramycin and Bactericidal Levels
At least two SST blood samples are required. Blood levels should be monitored after the 3rd or 4th dose and then depending on renal function, but at least twice per week. Please discuss with a Microbiologist if treatment is intended to exceed 5 days.
The first sample should be taken immediately pre-dose; the second sample, one hour after the dose has been administered. Please include clinical details, the dosage regimen, details of any renal impairment and whether the dose is IV or IM. Please send both samples together and notify the department if they are likely to arrive at weekends. Requests received by 11am Monday-Friday will be complete and telephoned by 12.30pm; those received by 4pm will be complete and phoned by 5.30pm. Stat requests are not available unless agreed by a Consultant Microbiologist.
| Desirable Levels: | |
| Tobramycin | Pre-dose (trough) level < 2mg/L |
| (divided dose regimen) | Post-dose (peak) level 5-10mg/L |
| Vancomycin | Pre-dose (trough) level 5-10mg/L |
| Post-dose (peak) level 20-40mg/L | |
The pre-dose level is the more important in assessing potential toxicity. Netilmicin assays are referred to either Oxford or Bristol laboratories. Transport has to be arranged, therefore prior notice MUST be given if undesirable delays are to be avoided.
All other antibiotic measurements must be discussed in advance with a Consultant Microbiologist.