Empiric (in combination) or targeted therapy for suspected or confirmed gram negative infections.
Empiric therapy for pyelonephritis.
Used synergistically in enterococcal endocarditis.
Pregnancy:
Breastfeeding:
Extended interval dosing:
Conventional dosing:
If therapy to be continued for greater than 7 days:
Nephrotoxicity (non-oliguric)- less common with once daily dosing; greater toxicity with longer duration and supratherapeutic trough levels; avoid concomitant nephrotoxins
Vestibulocochlear toxicity (irreversible)- require audiology testing if prolonged use
Can exacerbate neuromuscular blockade- e.g. contraindicated in patients with myasthenia gravis
Amphotericin, vancomycin, cyclosporin, NSAIDs, increased contrast-induced nephrotoxicity
Loop diuretics (e.g. furosemide)- increased ototoxicity
Non-depolarizing muscle relaxants may be potentiated
Inform patient of risk of ototoxicity to report any symptoms
Contraindicated in patients with myasthenia gravis
Antimicrobial class: Aminoglycoside
Average serum half life: 2.0
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic