II. Pharmacokinetics
- Maintain Trough <2 ug/ml
- Drawn immediately before next dose
- Maintain Peak at 5-8 ug/ml (4-6 ug/ml for child)
- Draw 1 hour after Intramuscular dose
- Indications for pharmacokinetics followed by PharmD
- Aminoglycoside use over 3 days
- Renal dysfunction
III. Precautions
- Administer IV dose over 1 hour
- Adjust dosing per kinetics if >1-2 days use
- Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)
IV. Dosing: Infants
- Term Infant
- Gentamycin 2.5 mg/kg/dose IV or IM q8 hours
-
Preterm Infant
-
Gestational age >34 weeks and Weight over 2000 grams
- Gentamycin 2.5 mg/kg/dose IV or IM q12 hours
-
Gestational age <34 weeks
- Weight over 1250 grams
- Gentamycin 2.5 mg/kg/dose IV or IM q18 hours
- Weight Under 1250 grams
- Gentamycin 2.5 mg/kg/dose IV or IM q24 hours
- Weight over 1250 grams
- Age >7 days
- Gentamycin 2.5 mg/kg/dose IV or IM q12 hours
-
Gestational age >34 weeks and Weight over 2000 grams
- Renal Impairment Adjustments
- Serum Creatinine 0.7 to 1.1
- Gentamycin 2.5 mg/kg/dose IV or IM q24 hours
- Serum Creatinine 1.1 to 1.3
- Gentamycin 2.5 mg/kg/dose IV or IM q36 hours
- Serum Creatinine > 1.3
- Gentamycin 2.5 mg/kg/dose IV or IM q48 hours
- Serum Creatinine 0.7 to 1.1
V. Dosing: Children and adults
- Child
- Gentamicin 2 to 2.5 mg/kg IV or IM q8 hours
- Gentamicin 4.5 mg/kg IV q24 hours
- Adults
- Gentamicin 1-1.5 mg/kg IV or IM q8 hours or
- Gentamicin 5-7 mg/kg IV q24 hours
VI. Risk Factors for Nephrotoxicity
- Advanced age
- Prior Renal Insufficiency
- Dehydration
- Hypokalemia
- Hypomagnesemia
- Liver disease
- Sepsis
-
Drug Interactions with other nephrotoxic medications
- Cephalothin (Keflin) and other Cephalosporins
- Cyclosporin A
- Cisplatin
- NSAIDS
- ACE Inhibitors
- Methoxyflurane
- Loop Diuretics
- Amino acids
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| Gentamicin (on 6/18/2017 at Walmart.com) | ||
| Gentamicin 0.3% op. soln (5ml) | #1 bottle for $4.00 | $4.00 each |
| Gentamicin 0.3% op. soln (5ml) | #3 bottles for $10.00 | $3.33 each |
| gentamicin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| GENTAMICIN 0.1% CREAM | Generic | $2.14 per gram |
| GENTAMICIN 0.1% OINTMENT | Generic | $2.05 per gram |
| GENTAMICIN 0.3% EYE DROPS | Generic | $1.05 per ml |
| GENTAMICIN 0.3% EYE OINTMENT | Generic | $3.81 per gram |
| GENTAMICIN 3 MG/ML EYE DROPS | Generic | $1.05 per ml |
| GENTAMICIN 80 MG/2 ML VIAL | Generic | $0.52 per ml |
Ontology: Antibiotics, Aminoglycoside (C0003233)
| Definition (NCI) | Any antibiotic containing amino-modified sugars originally isolated from various Streptomyces and Micromonospora species. Aminoglycoside antibiotics bind to the 16S RNA of the bacterial 30S ribosomal subunit, inhibiting translation and protein synthesis. Aminoglycoside use is associated with ototoxicity, neurotxicity and nephrotoxicity. |
| Definition (NCI_NCI-GLOSS) | A family of antibiotics that works against many types of bacteria and includes streptomycin, gentamicin, and neomycin. Aminoglycosides are used to treat bacterial infections. |
| Definition (CSP) | any of a group of antibiotics derived from various species of Streptomyces or produced synthetically; they inhibit protein synthesis by binding with the 30S ribosomal subunit. |
| Concepts | Antibiotic (T195) , Carbohydrate (T118) |
| SnomedCT | 14443002 |
| English | Antibiotics, Aminoglycoside, aminoglycosides, aminoglycosides (medication), aminoglycoside antibiotics, aminoglycosides antibiotics, AMINOGLYCOSIDE ANTIBACTERIALS, aminoglycoside antibiotic, Aminoglycoside -class of antibiotic- (substance), Aminoglycoside -class of antibiotic-, Aminoglycoside, NOS, Aminoglycosides, Aminoglycoside Agents, Aminoglycoside Antibiotic, Aminoglycoside Drugs |
| Spanish | aminoglucósido (clase de antibiótico) (sustancia), aminoglucósido (clase de antibiótico) |
Ontology: Gentamicin Sulfate (USP) (C0546866)
| Definition (CHV) | a kind of antibiotics |
| Definition (CHV) | a kind of antibiotics |
| Definition (MSH) | A complex antibiotic substance produced by MICROMONOSPORA purpurea, with three components: gentamicin C1, C2 , and C1A sulfates. |
| Definition (NCI) | The sulfate salt form of gentamycin, a broad-spectrum aminoglycoside antibiotic complex produced by the fermentation of Micromonospora purpurea or M. echinospora, with antibacterial activity. Gentamicin is a thermostable complex containing the gentamicins C1, C1a, C2, C2a and C2b. |
| Definition (NCI) | A broad-spectrum aminoglycoside antibiotic produced by fermentation of Micromonospora purpurea or M. echinospora. Gentamicin is an antibiotic complex consisting of four major (C1, C1a, C2, and C2a) and several minor components. This agent irreversibly binds to the bacterial 30S ribosomal subunit. Specifically, this antibiotic is lodged between 16S rRNA and S12 protein within the 30S subunit. This leads to interference with translational initiation complex, misreading of mRNA, thereby hampering protein synthesis and resulting in bactericidal effect. Aminoglycosides are mostly ineffective against anaerobic bacteria, fungi and viruses. |
| Definition (CSP) | complex of three different closely related aminoglycoside sulfates, obtained from Micromonospora purpurea and related species; broad-spectrum antibiotics; may cause ear and kidney damage; they act to inhibit protein synthesis. |
| Concepts | Antibiotic (T195) , Carbohydrate (T118) |
| MSH | D005839 |
| SnomedCT | 332830003, 330929002, 255967008, 330314006, 324117008, 387321007, 57752001, 2249001, 411310000 |
| LNC | LP15747-6, MTHU004260 |
| English | Gentamicins, Sulfate, Gentamicin, Gentamicin [ear], Gentamicin [eye], Gentamicin [infections], Gentamicin [skin], Gentamicin Sulfate (USP), gentamicin sulfate, gentamicin sulfate (medication), gentamicins (medication), gentamicins, GENTAMICIN, GENTAMICIN SULFATE, gentamicin, gentamicin sulphate, gentamycin sulphate, gentamycin sulfate, Gentamycin Complex, Gentamicin [skin] (product), Gentamicin [ear] (product), Gentamycin sulfate (substance), Gentamicin [eye] (product), Gentamicin [infections] (product), Gentamicin Sulfate [Chemical/Ingredient], Gentamicin, Gentamycin, Gentamicin sulfate, Gentamicin product, Gentamicin (product), Gentamicin (substance), Gentamicin sulfate (substance), Gentamicin sulphate, gentamycin, GM, Gentamicin [ear] (substance), Gentamicin [eye] (substance), Gentamicin [infections] (substance), Gentamicin [skin] (substance), Gentamycin sulfate, Gentamycin sulphate, Gentamycin sulfate (product), Gentamicin Sulfate |
| Portuguese | Sulfato de Gentamicina (USP) |
| Spanish | Sulfato de Gentamicina (USP), gentamicina (uso ótico), gentamicina (uso dermatológico), gentamicina (uso oftálmico), gentamicina (uso ótico) (producto), gentamicina (uso oftálmico) (producto), gentamicina [antinfeccioso], gentamicina (uso dermatológico) (producto), gentamicina [antinfeccioso] (producto), gentamicina, sulfato (sustancia), gentamicina (oftálmico) (producto), gentamicina (oftálmico), gentamicina (oído) (producto), gentamicina (oído), gentamicina (piel) (producto), gentamicina (piel), gentamicina (producto), gentamicina (sustancia), gentamicina [infecciones] (producto), gentamicina [infecciones], gentamicina, sulfato de gentamicina (sustancia), sulfato de gentamicina, gentamicina, sulfato, gentamicina, sulfato (producto) |
| German | Gentamycinsulfat, Gentamycine, Gentamicinsulfat, Gentamicin, Gentamycin, Gentamicine |
| Czech | gentamiciny |
| Finnish | Gentamysiinit |
| Russian | GENTAMITSINY |
| Japanese | ゲンタマイシン, ゲンタミシン |
| Croatian | GENTAMICINI |
| French | Gentamicine, Gentamycine |
| Italian | Gentamicine |
Ontology: Garamycin (C0699088)
| Concepts | Antibiotic (T195) , Carbohydrate (T118) |
| MSH | D005839 |
| German | Garamicin, Garamycin |
| English | garamycin, Garamycin |
