C. diff Risk


Oral Bioavailability


Approximate Cost



Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

General Information

Common Usage

  • Empiric (in combination) or targeted therapy for suspected or confirmed gram negative infections.

  • Empiric therapy for pyelonephritis.

  • Used synergistically in enterococcal endocarditis.

Adverse Effects

  • 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.

Major Interactions

  • 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.