Use Adjusted Body Weight for obese patients (BMI ≥30 kg/m2) Once Daily Dosing 5-7 mg/kg IV every 24 hr Multiple Daily Dosing 1.5-2 mg/kg IV every 8 hr Recommend dosing per Pharmacy Cystic Fibrosis 300 mg by inhalation every 12 hr
Pseudomonal and other gram negative infections.
Inhaled form used in cystic fibrosis.
Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.
For Multiple daily dosing: Target Peak 4-10 ug/mL, Trough 1-2 ug/mL.
For Once daily: Target Trough <1 ug/mL
Note: Trough level is 0-60 min before a dose (usually pre-4th), and peak is 30-60 min after dose infused (usually post-3rd).
Avoid concomitant nephrotoxins
Less common with once daily dosing
Greater toxicity with longer duration and supratherapeutic trough levels
Require audiology testing if prolonged use
Can exacerbate neuromuscular blockade
Contraindicated in patients with myasthenia gravis.
Neuromuscular blockade agents - Respiratory paralysis.
Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop.
Inform patient of risk of ototoxicity and to report any symptoms
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 3 hours
Urine penetration: Therapeutic
CSF penetration: Poor
Biliary penetration: Moderate
Lung penetration: Therapeutic