Antimicrobials
Gentamicin

Gentamicin

Low
N/A
$10-30/d

General Information

  • Empiric (in combination) or targeted therapy for suspected or confirmed gram negative infections
  • Empiric therapy for pyelonephritis
  • Used synergistically in enterococcal endocarditis
  • Nephrotoxicity (non-oliguric): less common with once daily dosing; greater toxicity with longer duration and supratherapeutic trough levels; avoid concomitant nephrotoxins
  • Vestibulocochlear toxicity (irreversible): suggest audiology testing if prolonged use
  • Can exacerbate neuromuscular blockade- e.g. contraindicated in patients with myasthenia gravis
  • Enhanced nephrotoxic effect with concomitant use of other nephrotoxins

  • Enhanced ototoxicity with loop diuretics (e.g. furosemide)

  • Non-depolarizing muscle relaxants may be potentiated

Antimicrobial class: Aminoglycoside

Average serum half life:

  • Neonates: 3-11.5 hours
  • Infants: 4 ± 1 hour
  • Children: 2 ± 1 hour
  • Adolescents:1.5 ± 1 hour
  • Adolescents: 1.5 ± 1 hour
  • Adults: 1.5- 3 hours; End stage renal disease: 30-70 hours

Route of Elimination: Almost completely by glomerular filtration of unchanged drug with excretion into urine