Gentamicin

General

Adult Dosing
  • All: If obese, use Adjusted Weight = IBW + 0.4 x (ABW - IBW)
  • All: Adjust repeat dosing based on levels

General
  • Extended Interval
    • 5-7mg/kg IV q24h
    • First Dose: 5-7mg/kg IV
  • Conventional
    • 1-1.7mg/kg IM/IV q8h

Uncomplicated Gonococcal
  • 240mg IM x 1

Severe PID
  • 1.5mg/kg IM/IV q8h
    • Start 2mg/kg IM/IV x 1
  • Alt: 3-5mg/kg IM/IV q24h
  • Info: Give with clindamycin

Pediatric Dosing
  • All: adjust repeat dosing based on levels

General (<8 Days Old)
  • First Dose All: 2.5mg/kg IV/IM x1
  • <28 weeks gestation
    • 2.5mg/kg IV/IM q24h
    • Alt: 5mg/kg IV/IM q48h
  • 28-29 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt: 5mg/kg IV/IM q48h
  • 30-33 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt 1: 3.5mg/kg IV/IM q24hr
    • Alt 2: 4.5mg/kg IV/IM q36-48h
  • 34 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt 1: 3.5mg/kg IV/IM q24hr
    • Alt 2: 4mg/kg IV/IM q24-36h
  • 35-36 weeks gestation
    • 2.5mg/kg IV/IM q 12h
    • Alt 1: 3.5mg/kg IV/IM q24
    • Alt 2: 4mg/kg IV/IM q24-36h
  • Full Term
    • 2.5mg/kg IV/IM q12h
    • Alt: 4mg/kg IV/IM q24h

General (8 Days - 1 Month)
  • First Dose All: 2.5mg/kg IV/IM x1
  • <30 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt: 4mg/kg IV/IM q24-36h
  • 30-33 weeks gestation
    • 2.5mg/kg IV/IM q12h
    • Alt: 4mg/kg IV/IM q24
  • 34 weeks gestation
    • 2.5mg/kg IV/IM q12h
    • Alt: 4mg/kg IV/IM q18h
  • 35-36 weeks gestation
    • 2.5mg/kg IV/IM q8h
    • Alt: 4mg/kg IV/IM q12h
  • Full term
    • 2.5mg/kg IV/IM q8h
    • Alt: 4mg/kg IV/IM q24h

General (1 Month -6 Months)
  • 2.5mg/kg IV/IM q8h
  • Alt: 6.5mg/kg IV/IM q24h

General (>6 Months)
  • 2.5mg/kg IV/IM
  • Alt: 6.5-7.5mg/kg IV/IM q24h
  • Use IBW if >2yo

Special Populations
  • Pregnancy Rating: D
  • Lactation: Probably safe
  • Renal Dosing
    • Adult
      • Conventional interval dosing
        • CrCl 10-50: give q12-48h
        • CrCl <10: give q48-72h
        • Hemodialysis: give 1-1.7mg/kg after dialysis
      • Extended interval dosing
      • CrCl 30-60: increase dosing interval based on levels
      • CrCl <30: avoid use
    • Pediatric
      • Conventional interval dosing
        • CrCl 30-50: give q12-48h
        • CrCl: 10-29: Give q18-24h
        • CrCl <10: give q48-72h
        • Hemodialysis/peritoneal dialysis: give 2mg/kg after dialysis
      • Extended interval dosing
      • CrCl 30-60: increase dosing interval based on levels
      • CrCl <30: avoid use
  • Hepatic Dosing (Adult & Pediatric)
    • Not defined

Contraindications
  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology
  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

Antibiotic Sensitivities[1]
Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GR
Strep. PneumoniaeR
Viridans strepX1
Strep. anginosus gpX1
Enterococcus faecalisS
Enterococcus faeciumS
MSSAS
MRSAR
CA-MRSAX1
Staph. EpidermidisI
C. jeikeiumR
L. monocytogenesS
Gram NegativesN. gonorrhoeaeR
N. meningitidisR
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+S
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negS
Enterobacter sp, AmpC posS
Serratia spX1
Serratia marcescensS
Salmonella spX1
Shigella spS
Proteus mirabilisX1
Proteus vulgarisS
Providencia sp.X1
Morganella sp.X1
Citrobacter freundiiX1
Citrobacter diversusX1
Citrobacter sp.X1
Aeromonas spX1
Acinetobacter sp.R
Pseudomonas aeruginosaS
Burkholderia cepaciaR
Stenotrophomonas maltophiliaR
Yersinia enterocoliticaS
Francisella tularensisS
Brucella sp.S+'
Legionella sp.X1
Pasteurella multocidaX1
Haemophilus ducreyiX1
Vibrio vulnificusI
MiscChlamydophila spR
Mycoplasm pneumoniaeR
Rickettsia spR
Mycobacterium aviumX1
AnaerobesActinomycesR
Bacteroides fragilisR
Prevotella melaninogenicaR
Clostridium difficileR
Clostridium (not difficile)X1
Fusobacterium necrophorumR
Peptostreptococcus sp.R

Key
  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References
  1. Sanford Guide to Antimicrobial Therapy 2014
This article is issued from Wikem. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.