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obese patients. 19 ICUs defined obesity as an actual body weight (ABW) of greater than 20% of patients’ IBW whilst 4 ICUs used a cut off of 15%. 3 ICUs defined obesity using the body mass index (BMI) scale. Maximum initial gentamicin doses ranged from 450mg to 600mg and 5 ICUs had no maximum defined dose. 20 of the ICUs (75%) used trough levels to guide gentamicin re-dosing and the remaining 7 (25%) used a nomogram. 14 ICUs (52%) had no specific protocols to guide dosing for patients undergoing RRT. 10 ICUs (37%) dosed these patients with a defined dose per kilogram (ranging from 3 to 7mg/kg) and then used trough levels to guide re-dosing. 2 units (7%) used three times a day dosing and one unit reported they avoided gentamicin in RRT. Conclusions There is a large variation in the dose, maximum dose and re-dosing of gentamicin across ICUs. Those patients undergoing RRT have aw ide variability in the total dose that could potentially be administered. Further work must be done to determine whether there are correlations between the different dosing regimes and outcomes. This preliminary work has highlighted the current aminoglycoside dose variability and we intend to further this work by extending it across the United Kingdom.

Variability in aminoglycoside dosing in intensive care units across London - should our methods be standardised?