Any post-conceptual age at high risk for Gentamicin toxicity
Including
- Weight less than or equal to 1250g
- Hypoxic ischemic encephalopathy
- Concurrent nephrotoxic medications
- Concurrent indomethacin/ibuprofen
- Hemodynamic instability, and/or
- Renal dysfunction at start of therapy (urine output less than 1mL/kg/hr OR Scr increase of 30% or more from baseline or expected baseline)
- Intrauterine growth restriction (IUGR); Consider contacting pharmacist for further guidance on dosing
All PNA with above risk factors
5mg/kg/DOSE IV q48h
Post conceptual age less than or equal to 29 weeks
All PNA
5mg/kg/DOSE IV q48h
Post conceptual age greater than 29 weeks to less than 35 weeks
PNA less than or equal to 7 days
5mg/kg/DOSE IV q36h
PNA greater than 7 days
5mg/kg/DOSE IV q24h
Post conceptual age greater than or equal to 35 weeks
All PNA
5mg/kg/DOSE IV q24h