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.