Gentamicin
(Redirected from Gentamycin)
General
- Type: Aminoglycosides
- Dosage Forms: IM; IV
- Common Trade Names: Genticyn, Garamycin, Gentak
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
- Conventional interval dosing
- 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
- Conventional interval dosing
- Adult
- Hepatic Dosing (Adult & Pediatric)
- Not defined
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Ototoxicity[1]
- Nephrotoxicity
- Prolongation of neuromuscular blockers
Common
- Nausea/vomiting
- Irritation at injection site
Pharmacology
- Half-life:2-3 hours
- Metabolism:
- Excretion: Urine excretion
- Mechanism of Action: Binds to 30S and 50S ribosomal subunits, disrupting mRNA translation and interfering with bacterial protein synthesis[2]
Antibiotic Sensitivities[3]
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
- ↑ https://www.drugs.com/monograph/gentamicin-systemic.html
- ↑ Chaves BJ, Tadi P. Gentamicin. [Updated 2022 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557550/
- ↑ Sanford Guide to Antimicrobial Therapy 2014