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]]=== | ===Uncomplicated [[Gonococcal]]=== | ||
* | *240mg IM x 1 | ||
===Severe [[PID]]=== | ===Severe [[PID]]=== | ||
*1. | *1.5mg/kg IM/IV q8h | ||
**Start | **Start 2mg/kg IM/IV x 1 | ||
*Alt: 3- | *Alt: 3-5mg/kg IM/IV q24h | ||
*Info: Give with [[clindamycin]] | *Info: Give with [[clindamycin]] | ||
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===General (<8 Days Old)=== | ===General (<8 Days Old)=== | ||
*'''First Dose All: 2. | *'''First Dose All: 2.5mg/kg IV/IM x1''' | ||
*<28 weeks gestation | *<28 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q24h | ||
**Alt: | **Alt: 5mg/kg IV/IM q48h | ||
*28-29 weeks gestation | *28-29 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q18h | ||
**Alt: | **Alt: 5mg/kg IV/IM q48h | ||
*30-33 weeks gestation | *30-33 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q18h | ||
**Alt 1: 3. | **Alt 1: 3.5mg/kg IV/IM q24hr | ||
**Alt 2: 4. | **Alt 2: 4.5mg/kg IV/IM q36-48h | ||
*34 weeks gestation | *34 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q18h | ||
**Alt 1: 3. | **Alt 1: 3.5mg/kg IV/IM q24hr | ||
**Alt 2: 4mg/kg IV/IM q24-36h | **Alt 2: 4mg/kg IV/IM q24-36h | ||
*35-36 weeks gestation | *35-36 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q 12h | ||
**Alt 1: 3. | **Alt 1: 3.5mg/kg IV/IM q24 | ||
**Alt 2: 4mg/kg IV/IM q24-36h | **Alt 2: 4mg/kg IV/IM q24-36h | ||
*Full Term | *Full Term | ||
**2. | **2.5mg/kg IV/IM q12h | ||
**Alt: 4mg/kg IV/IM q24h | **Alt: 4mg/kg IV/IM q24h | ||
===General (8 Days - 1 Month)=== | ===General (8 Days - 1 Month)=== | ||
*'''First Dose All: 2. | *'''First Dose All: 2.5mg/kg IV/IM x1''' | ||
*<30 weeks gestation | *<30 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q18h | ||
**Alt: 4mg/kg IV/IM q24-36h | **Alt: 4mg/kg IV/IM q24-36h | ||
*30-33 weeks gestation | *30-33 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q12h | ||
**Alt: 4mg/kg IV/IM q24 | **Alt: 4mg/kg IV/IM q24 | ||
*34 weeks gestation | *34 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q12h | ||
**Alt: 4mg/kg IV/IM q18h | **Alt: 4mg/kg IV/IM q18h | ||
*35-36 weeks gestation | *35-36 weeks gestation | ||
**2. | **2.5mg/kg IV/IM q8h | ||
**Alt: 4mg/kg IV/IM q12h | **Alt: 4mg/kg IV/IM q12h | ||
*Full term | *Full term | ||
**2. | **2.5mg/kg IV/IM q8h | ||
**Alt: 4mg/kg IV/IM q24h | **Alt: 4mg/kg IV/IM q24h | ||
===General (1 Month -6 Months)=== | ===General (1 Month -6 Months)=== | ||
*2. | *2.5mg/kg IV/IM q8h | ||
*Alt: 6. | *Alt: 6.5mg/kg IV/IM q24h | ||
===General (>6 Months)=== | ===General (>6 Months)=== | ||
*2. | *2.5mg/kg IV/IM | ||
*Alt: 6.5-7. | *Alt: 6.5-7.5mg/kg IV/IM q24h | ||
*Use IBW if >2yo | *Use IBW if >2yo | ||
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****CrCl 10-50: give q12-48h | ****CrCl 10-50: give q12-48h | ||
****CrCl <10: give q48-72h | ****CrCl <10: give q48-72h | ||
****Hemodialysis: give 1-1. | ****Hemodialysis: give 1-1.7mg/kg after dialysis | ||
***Extended interval dosing | ***Extended interval dosing | ||
***CrCl 30-60: increase dosing interval based on levels | ***CrCl 30-60: increase dosing interval based on levels | ||
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****CrCl: 10-29: Give q18-24h | ****CrCl: 10-29: Give q18-24h | ||
****CrCl <10: give q48-72h | ****CrCl <10: give q48-72h | ||
****Hemodialysis/peritoneal dialysis: give | ****Hemodialysis/peritoneal dialysis: give 2mg/kg after dialysis | ||
***Extended interval dosing | ***Extended interval dosing | ||
***CrCl 30-60: increase dosing interval based on levels | ***CrCl 30-60: increase dosing interval based on levels | ||
Line 241: | Line 241: | ||
*[[Antibiotics (Main)]] | *[[Antibiotics (Main)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[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