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
NB: 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.
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Can exacerbate neuromuscular blockade
Increased nephrotoxicity
Increased ototoxicity
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
Lung penetration: Therapeutic
CSF penetration: Poor
Biliary penetration: Moderate