Gentamicin: Difference between revisions
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===General=== | ===General=== | ||
*Extended Interval | *Extended Interval | ||
**5- | **5-7mg/kg IV q24h | ||
**First Dose: 5- | **First Dose: 5-7mg/kg IV | ||
*Conventional | *Conventional | ||
**1-1. | **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== | ==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== | ==Special Populations== | ||
*Pregnancy: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D | ||
*Lactation: | *Lactation: Probably safe | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **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 | |||
**Pediatric | **Pediatric | ||
* | ***Conventional interval dosing | ||
**Adult | ****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 | |||
*Hepatic Dosing (Adult & Pediatric) | |||
**Not defined | |||
==Contraindications== | ==Contraindications== | ||
Line 40: | Line 115: | ||
*Excretion: | *Excretion: | ||
*Mechanism of Action: | *Mechanism of Action: | ||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | |||
{| class="wikitable" | |||
| align="center" style="background:#f0f0f0;"|'''Group''' | |||
| align="center" style="background:#f0f0f0;"|'''Organism''' | |||
| align="center" style="background:#f0f0f0;"|'''Sensitivity''' | |||
|- | |||
| Gram Positive||[[Strep. Group A, B, C, G]]||R | |||
|- | |||
| ||[[Strep. Pneumoniae]]||R | |||
|- | |||
| ||[[Viridans strep]]||X1 | |||
|- | |||
| ||Strep. anginosus gp||X1 | |||
|- | |||
| ||[[Enterococcus faecalis]]||'''S''' | |||
|- | |||
| ||[[Enterococcus faecium]]||'''S''' | |||
|- | |||
| ||[[MSSA]]||'''S''' | |||
|- | |||
| ||[[MRSA]]||R | |||
|- | |||
| ||[[CA-MRSA]]||X1 | |||
|- | |||
| ||[[Staph. Epidermidis]]||I | |||
|- | |||
| ||[[C. jeikeium]]||R | |||
|- | |||
| ||[[L. monocytogenes]]||'''S''' | |||
|- | |||
| Gram Negatives||[[N. gonorrhoeae]]||R | |||
|- | |||
| ||[[N. meningitidis]]||R | |||
|- | |||
| ||[[Moraxella catarrhalis]]||'''S''' | |||
|- | |||
| ||[[H. influenzae]]||'''S''' | |||
|- | |||
| ||[[E. coli]]||'''S''' | |||
|- | |||
| ||[[Klebsiella]] sp||'''S''' | |||
|- | |||
| ||E. coli/Klebsiella ESBL+||'''S''' | |||
|- | |||
| ||E coli/Klebsiella KPC+||R | |||
|- | |||
| ||[[Enterobacter]] sp, AmpC neg||'''S''' | |||
|- | |||
| ||[[Enterobacter]] sp, AmpC pos||'''S''' | |||
|- | |||
| ||[[Serratia]] sp||X1 | |||
|- | |||
| ||Serratia marcescens||'''S''' | |||
|- | |||
| ||[[Salmonella]] sp||X1 | |||
|- | |||
| ||[[Shigella]] sp||'''S''' | |||
|- | |||
| ||[[Proteus mirabilis]]||X1 | |||
|- | |||
| ||[[Proteus vulgaris]]||'''S''' | |||
|- | |||
| ||[[Providencia sp.]]||X1 | |||
|- | |||
| ||[[Morganella sp.]]||X1 | |||
|- | |||
| ||[[Citrobacter freundii]]||X1 | |||
|- | |||
| ||[[Citrobacter diversus]]||X1 | |||
|- | |||
| ||[[Citrobacter sp.]]||X1 | |||
|- | |||
| ||[[Aeromonas sp]]||X1 | |||
|- | |||
| ||[[Acinetobacter sp.]]||R | |||
|- | |||
| ||[[Pseudomonas aeruginosa]]||'''S''' | |||
|- | |||
| ||[[Burkholderia cepacia]]||R | |||
|- | |||
| ||[[Stenotrophomonas maltophilia]]||R | |||
|- | |||
| ||[[Yersinia enterocolitica]]||'''S''' | |||
|- | |||
| ||[[Francisella tularensis]]||'''S''' | |||
|- | |||
| ||[[Brucella sp.]]||''S+''' | |||
|- | |||
| ||[[Legionella sp.]]||X1 | |||
|- | |||
| ||[[Pasteurella multocida]]||X1 | |||
|- | |||
| ||[[Haemophilus ducreyi]]||X1 | |||
|- | |||
| ||[[Vibrio vulnificus]]||I | |||
|- | |||
| Misc||[[Chlamydophila sp]]||R | |||
|- | |||
| ||[[Mycoplasm pneumoniae]]||R | |||
|- | |||
| ||[[Rickettsia sp]]||R | |||
|- | |||
| ||[[Mycobacterium avium]]||X1 | |||
|- | |||
| Anaerobes||[[Actinomyces]]||R | |||
|- | |||
| ||[[Bacteroides fragilis]]||R | |||
|- | |||
| ||[[Prevotella melaninogenica]]||R | |||
|- | |||
| ||[[Clostridium difficile]]||R | |||
|- | |||
| ||[[Clostridium (not difficile)]]||X1 | |||
|- | |||
| ||[[Fusobacterium necrophorum]]||R | |||
|- | |||
| ||[[Peptostreptococcus sp.]]||R | |||
|} | |||
===Key=== | |||
{{Template:Antibacterial Spectra Key}} | |||
==See Also== | ==See Also== | ||
*[[Antibiotics (Main)]] | *[[Antibiotics (Main)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] |
Revision as of 05:07, 24 October 2017
General
- Type: Aminoglycosides
- Dosage Forms: IM; IV
- Common Trade Names:
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
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
Antibiotic Sensitivities[1]
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
- ↑ Sanford Guide to Antimicrobial Therapy 2014