Version July 2025
| Aminoglycosides for newborns (≤28 days of age) | |||||||
| Drug | Route | Dose (based on gestational and postnatal age) | |||||
| GA ≤29 weeks 6 days | GA 30 weeks 0 days to 34 weeks 6 days | GA ≥35 weeks 0 days | |||||
| PNA ≤14 days | PNA >14 days | PNA ≤10 days | PNA >10 days | PNA ≤7 days | PNA >7 days | ||
| Amikacin* | IV, IM | 15 mg/kg every 48 hours | 15 mg/kg every 36 hours | 15 mg/kg every 36 hours | 15 mg/kg every 24 hours | 15 mg/kg every 24 hours | 18 mg/kg every 24 hours |
| Gentamicin¶ | IV, IM | 5 mg/kg every 48 hours | 5 mg/kg every 36 hours | 5 mg/kg every 36 hours | 5 mg/kg every 24 hours | 4 mg/kg every 24 hours | 5 mg/kg every 24 hours |
| Tobramycin¶ | IV, IM | 5 mg/kg every 48 hours | 5 mg/kg every 36 hours | 5 mg/kg every 36 hours | 5 mg/kg every 24 hours | 4 mg/kg every 24 hours | 5 mg/kg every 24 hours |
| Aminoglycosides for pediatric patients beyond the newborn period | |||||||
| Drug | Route | Dose | Comments | ||||
| Amikacin*Δ | IV, IM | 15 to 22.5 mg/kg/day divided in 2 to 3 doses or administered once daily | Higher doses than those given are appropriate for cystic fibrosis. | ||||
| Gentamicin¶Δ | IV, IM | 6 to 7.5 mg/kg/day divided in 3 doses or 5 to 7.5 mg/kg once daily | |||||
| Tobramycin¶Δ | IV, IM | 6 to 7.5 mg/kg/day divided in 3 to 4 doses or 5 to 7.5 mg/kg once daily | Higher doses than those given are appropriate for cystic fibrosis. | ||||
Dosing in this table reflects recommendations from the American Academy of Pediatrics. It is intended for patients with normal kidney function; refer to drug monographs included within UpToDate for dose adjustments. For discussion of dosing weight in patients with obesity, refer to UpToDate content on parenteral aminoglycoside dosing.
Aminoglycosides are not ideal for central nervous system infections.GA: gestational age; IM: intramuscular; IV: intravenous; MIC: minimum inhibitory concentration; PNA: postnatal age.
* Desired serum or plasma concentrations: 20 to 40 mcg/mL or 10 × MIC (peak), <7 mcg/mL (trough).
¶ Desired serum or plasma concentrations: 6 to 12 mcg/mL or 10 × MIC (peak), <2 mcg/mL (trough).
Δ Extended-interval ("once daily") dosing may provide equal efficacy with reduced toxicity.