gentamicin

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

gentamicin

Indication

  • An aminoglycoside used to treat documented or suspected Gram-negative sepsis and meningitis.
  • Used in combination with ampicillin as empiric therapy for early onset sepsis in term and preterm infants.

Dosage Guidelines

Postnatal Age

Post Menstrual Age

Dose

0 to 7 days

Less than 35 weeks

3 mg/kg/dose IV/IM q24h

Greater than or equal to 35 weeks

3.5 mg/kg/dose IV/IM q24h

Greater than 7 days

Less than or equal to 26 weeks

3.5 mg/kg/dose IV/IM q24h

27 to 32 weeks

3.5 mg/kg/dose IV/IM q18h

Greater than 32 weeks

3.5 mg/kg/dose IV/IM q12h

Administration

  • IV intermittent slow infusion over 30 minutes
  • IM (if no IV available)

Adverse Effects

  • Ototoxicity
  • Nephrotoxicity

Comments

  • Monitor urine output, renal function (serum creatinine, urea)
  • Administration with furosemide and vancomycin may cause additive oto/nephrotoxicity
  • Prolong dosing interval in renal impairment or consider using cefotaxime
  • Neuromuscular blockage and respiratory failure may be compounded if treating with rocuronium or other muscular blocking agents
  • Hold gentamicin levels if planning to discontinue antibiotics pending negative 48hr blood culture.  If treatment is planned for more than 48 hours, draw serum levels pre and post the 3rd dose.  Draw the pre-level (trough) just prior to administering the dose.  Draw the post-level (peak) 30 minutes after the infusion is finished.
  • Target trough concentration is less than 1.4 mg/L and target peak concentration is between 6 – 10 mg/L.

Supplied As

  • 10 mg/mL vial
  • 10 mg/mL patient specific syringe, prepared by Pharmacy