Calculate dose as above up to a MAXIMUM of 500mg OD.
If CrCl is <30ml/min consider alternative and discuss with microbiology/pharmacy.
Give dose in 50-100ml of Sodium chloride 0.9% over 30 minutes.
Trough levels should be checked immediately before the second dose. Dose should be given and adjustment made to third dose if needed. Always consider timing of the level when interpreting results.
Trough levels should be <1mg/L, if higher please follow table below