Gentamicin

General

• Type: Aminoglycosides
• Dosage Forms: IM; IV
• Common Trade Names:

Adult Dosing

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

General

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

Uncomplicated Gonococcal

• 240 mg IM x 1

Severe PID

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

Pediatric Dosing

• All: adjust repeat dosing based on levels

General (<8 Days Old)

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

General (8 Days - 1 Month)

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

General (1 Month -6 Months)

• 2.5 mg/kg IV/IM q8h
• Alt: 6.5 mg/kg IV/IM q24h

General (>6 Months)

• 2.5 mg/kg IV/IM
• Alt: 6.5-7.5 mg/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 1-1.7 mg/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 2 mg/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

Pharmacology

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

See Also

• Antibiotics (Main)