GENERIC NAME: Gentamicin

Drug Class: Aminoglycoside antibiotics

Dosage:
Adult and Pediatric Dosage Forms and Strengths
Injectable solution
10 mg/ml
40 mg/ml
Dosage Considerations – Should be Given as Follows:
Susceptible Infections
Adult
Conventional dosing
3-5 mg/kg/day intravenously/intramuscularly (IV/IM) divided every 8
hours
Extended dosing interval (every 24 hours or more)
Initial: 4-7 mg/kg/dose IV once/day
Base dose on lean body weight
Subsequent doses: Consult pharmacist
Pediatric
Children 5 years and older: 2-2.5 mg/kg/dose
intravenously/intramuscularly (IV/IM) every 8 hours
Children under 5 years: 2.5 mg/kg/dose IV/IM every 8 hours
Infants under 30 weeks' gestation
0-28 days: 2.5 mg/kg/day IV/IM
More than 28 days: 3 mg/kg/day IV/IM
Infants 30-36 weeks' gestation
0-14 days: 3 mg/kg/day IV/IM
More than 14 days: 5 mg/kg/day IV/IM divided every 12 hours
Infants over 36 weeks' gestation
0-7 days: 5 mg/kg/day IV/IM divided every 12 hours
More than 7 days: 7.5 mg/kg/day IV/IM divided every 8 hours
MECHANISM OF ACTION
Following parenteral administration, gentamicin (gentamicin
injection pediatric) can be detected in serum, lymph, tissues,
sputum, andinpleural, synovial, and peritoneal fluids. Concentrations
in renal cortex sometimes may be eight times higher than the usual
serum levels. Concentrations in bile, in general, have been low and
have suggested minimal biliary excretion. Gentamicin (gentamicin
injection pediatric) crosses the peritoneal as well as the placental
membranes.Since aminoglycosides diffuse poorly into the
subarachnoid space after parenteral administration, concentrations
of gentamicin (gentamicin injection pediatric) in cerebrospinal fluid
are often low and dependent upon dose, rate of penetration, and
degree of meningeal inflammation.There is minimal penetration of
gentamicin (gentamicin injection pediatric) into ocular tissues
following intramuscular or intravenous administration.
INDICATIONS
To reduce the development of drug-resistant bacteria and maintain
the effectiveness of Gentamicin Injection, USP (gentamicin injection
pediatric) and other antibacterial drugs, Gentamicin Injection, USP
(gentamicin injection pediatric) should be used only to treat or
prevent infections that are proven or strongly suspected to be
caused by bacteria.
CONTRAINDICATIONS
Hypersensitivity to gentamicin (gentamicin injection pediatric) is a
contraindication to its use. A history of hypersensitivity or serious
toxic reactions to other aminoglycosides may contraindicate use of
gentamicin (gentamicin injection pediatric) because of the known
cross-sensitivity of patients to drugs in this class.
ADVERSE EFFECTS
Common side effects of gentamicin include:
Neurotoxicity (spinning sensation [vertigo], loss of control of bodily
movements)
Gait instability
Ototoxicity (auditory, vestibular)
Kidney damage (decreased CrCl)
Kidney damage if trough greater than 2 mg/L
Swelling (edema)
Rash
Itching
Stomach upset
Injection site reactions (pain, irritation, and redness)
Less common side effects of gentamicin include:
Drowsiness
Headache
Pseudomotor cerebri
Photosensitivity
Allergic reaction
Skin redness
Loss of appetite
Nausea/vomiting
Weight loss
Increased salivation
Enterocolitis
Granulocytopenia
Agranulocytosis
Low platelet counts (thrombocytopenia)
Elevated liver function tests (LFTs)
Burning
Stinging
Tremors
Muscle cramps
Weakness
Shortness of breath
Serious side effects of gentamicin include:
Ringing or roaring sounds in the ear
Hearing loss
Dizziness
An unusual decrease in the amount of urine while using gentamicin
injection (pediatric)
NURSING RESPONSIBILITIES
Patients should be counseled that antibacterial drugs including
Gentamicin (gentamicin injection pediatric) Injection should only be
used to treat bacterial infections. They do not treat viral infections
(e.g., the common cold). When Gentamicin (gentamicin injection
pediatric) Injection is prescribed to treat a bacterial infection,
patients should be told that although it is common to feel better
early in the course of therapy, the medication should be taken
exactly as directed. Skipping doses or not completing the full course
of therapy may (1) decrease the effectiveness of the immediate
treatment and (2) increase the likelihood that bacteria will develop
resistance and will not be treatable by Gentamicin (gentamicin
injection pediatric) Injection or other antibacterial drugs in the
future.