Antimicrobials
Gentamicin (Garamycin)

Gentamicin (Garamycin)

Low
N/A
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General Information

Empiric (in combination) or targeted therapy for suspected or confirmed gram negative infections.

Empiric therapy for pyelonephritis. Used synergistically in enterococcal endocarditis.

Laboratory Monitor creatinine at least 2 times/week. Discontinue if any signs of nephro or ototoxicity.

Extended Interval Dosing: Target trough <1mcg/mL

Traditional Dosing: Peak monitoring poorly supported by literature, but target peak 8-10mcg/mL; trough < 1 mcg/mL only if using >4 days

Note: Trough level is 0-60min before a dose (usually pre-4th), and peak is 30-60min after dose infused (usually post-3rd).

In critically ill patients, check peak level after the 1st dose as volume of distribution and renal function may change rapidly.

Clinical Baseline and periodic hearing and vestibular function (questioning audiologic testing with prolonged therapy)

  • Nephrotoxicity
  • Auditory toxicity
  • Vestibular toxicity
  • Neuromuscular blockade

Seek consult if planned to use during pregnancy - avoid use.

Amphotericin, vancomycin, cyclosporin, NSAIDs, contrast- increased nephrotoxicity

Loop diuretics (e.g. furosemide)- increased ototoxicity

Non-depolarizing muscle relaxants may be potentiated

Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop

Inform patient of risk of ototoxicity to report any symptoms

Antimicrobial class: Aminoglycoside

Average serum half life: 2 hours

Biliary penetration: Moderate

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Therapeutic