Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Gentamicin

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Pediatric

Neonatal

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing

General Information

Drug Monitoring

Drug Monitoring

Monitor creatinine at least weekly and more often if levels are elevated or other signs of renal dysfunction arise

Discontinue if any signs of ototoxicity (tinnitus, fullness in ears, dizziness)

Serum Level Monitoring for EXTENDED Interval Dosing, pediatrics:
For most patients and indications, no levels are necessary, unless: Patients suspected at high risk for development of nephrotoxicity or renal dysfunction, or duration of treatment more than 5 days. In these cases check 10-12 hour level and plot on hartford nomogram

Serum Level Monitoring for EXTENDED Interval Dosing, neonates:
If plan is to discontinue gentamicin pending 48-hour culture results, no levels are required unless indicated for renal dysfunction. If plan is to continue antibiotics beyond 5 days, Goal level less than 1 mcg/mL

Major Interactions

Major Interactions

Enhanced nephrotoxic effect with concomitant use of other nephrotoxins

Enhanced ototoxicity with loop diuretics (e.g. furosemide)

Non-depolarizing muscle relaxants may be potentiated

Pharmacology

Pharmacology

Antimicrobial class: Aminoglycoside

Average serum half life: - Neonates: 3-11.5 hours

  • Infants: 4 ± 1 hour

  • Children: 2 ± 1 hour

  • Adolescents:1.5 ± 1 hour

  • Adolescents: 1.5 ± 1 hour

  • Adults: 1.5- 3 hours; End stage renal disease: 30-70 hours

Biliary Penetration: Good with q24hr dosing

Route of Elimination: Almost completely by glomerular filtration of unchanged drug with excretion into urine