A.     Available monitors

Complete blood count (CBC) with differential for hematopoietic effect

Serum chemistries for specific effects (e.g., electrolyte depletion, hepatic and renal toxicity)

Serum levels for specific antibiotics

Audiologic testing

Urinalysis for glycosuria, albuminuria, and hematuria

Quantitative urine samples for sodium and potassium

Nucleotide glomerular filtration rate or creatinine clearance

B.     Specific monitoring

1. Gentamicin and tobramycin

a.     Check serum creatinine, blood urea nitrogen (BUN),

and electrolytes every other day to monitor renal function. When creatinine rises over baseline, monitor

renal function daily.

b.     Check peak and trough serum levels of antibiotic after

24 hours at a fixed dose.

2.     Amphotericin B

a.     Monitor serum creatinine, BUN, serum electrolytes,

particularly serum sodium, potassium, and magnesium

(supplemental K+ almost always necessary), at 1- to 3-

day intervals.

b.     With significant persistent abnormality, adjust the

frequency of administration to every other day or less

frequently.

c.     Check creatinine clearance or nucleotide glomerular

filtration rate as indicated.

3.     Vancomycin

Monitor serum antibiotic levels. Aim for a peak level of 20-24 ug/mL and a trough level of 5-10 ug/mL.

4.     Nafcillin

Monitor liver transaminases.

*14\168\2*

Cancer