Gentamicin
Adult

Adult

High Dose Once Daily Dosing (See MSH Policy)

5-7 mg/kg Q24H based on dosing body weight (DBW).

For s. viridans endocarditis treatment: 3 mg/kg based on DBW.

See notes below for determination of DBW.

Conventional Multiple Daily Dosing (See MSH Policy)

Usual recommendations by indication:

UTI: 1 mg/kg/dose based on DBW

Gram-negative sepsis or serious infections : 1.5-2 mg/kg based on DBW

Pneumonia: 2 mg/kg/dose based on DBW

Synergy dosing: 1 mg/kg/dose based on DBW

Interval between doses is based on patient's renal function (see MSH policy)

See notes below for determination of DBW.

Determination of DBW

This value is determined by considering the patient’s actual weight (ABW) and Ideal body weight (IBW).

Use the equations below to determine DBW.

Female: IBW = 45.5 kg + (2.3 X inches over 5')

Male: IBW = 50 kg + (2.3 X inches over 5')

  • If ABW greater than IBW (but not more than 30% over IBW), use DBW = IBW
  • If ABW greater than IBW (more than 30% over IBW), use DBW = IBW + 0.4 (ABW - IBW)
  • If ABW less than IBW, use ABW

Notes

Once-daily therapy is recommended for treatment of most infections in most patients, with some exceptions.

Due to lack of published experience with once daily dosing, traditional multiple daily dosing is recommended for: septic shock (during initial hemodynamic instability), CrCl less than 40 mL/min, dialysis, ascites, burns, endocarditis, meningitis, osteomyelitis, pregnancy, post-partum less than 7 days, surgical prophylaxis and synergy dosing with beta-lactam or vancomycin for enterococci.