Diferencia entre revisiones de «Gentamicin»
(Remove disease-specific entries now covered by AntibioticDose (1 sections))
 
(No se muestran 23 ediciones intermedias de 7 usuarios)
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==General==
==General==
*Type: [[Aminoglycosides]]
*Type: [[Is DrugClass::Aminoglycoside]]
*Dosage Forms: IM; IV
*Dosage Forms: IM; IV
*Common Trade Names:  
*Common Trade Names: Genticyn, Garamycin, Gentak


==Adult Dosing==
==Adult Dosing==
Línea 10: Línea 10:
===General===
===General===
*Extended Interval
*Extended Interval
**5-7 mg/kg IV q24h
**5-7mg/kg IV q24h
**First Dose: 5-7 mg/kg IV
**First Dose: 5-7mg/kg IV
*Conventional
*Conventional
**1-1.7 mg/kg IM/IV q8h
**1-1.7mg/kg IM/IV q8h


===Uncomplicated [[Gonococcal]]===
*240 mg IM x 1


===Severe [[PID]]===
===Indications by Disease===
*1.5 mg/kg IM/IV q8h
{{#ask: [[Has DrugName::Gentamicin]] [[Has Population::Adult]]
**Start 2 mg/kg IM/IV x 1
|?Treats disease=Disease
*Alt: 3-5 mg/kg IM/IV q24h
|?Has Dose=Dose
*Use with [[clindamycin]]
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
*'''All: adjust dose based on levels'''
*'''All: adjust repeat dosing based on levels'''


===General (<8 Days Old)===
===General (<8 Days Old)===
*'''First Dose All: 2.5 mg/kg IV/IM x1'''
*'''First Dose All: 2.5mg/kg IV/IM x1'''
*<28 weeks gestation
*<28 weeks gestation
**2.5 mg/kg IV/IM q24h
**2.5mg/kg IV/IM q24h
**Alt: 5 mg/kg IV/IM q48h
**Alt: 5mg/kg IV/IM q48h
*28-29 weeks gestation
*28-29 weeks gestation
**2.5 mg/kg IV/IM q18h
**2.5mg/kg IV/IM q18h
**Alt: 5 mg/kg IV/IM q48h
**Alt: 5mg/kg IV/IM q48h
*30-33 weeks gestation
*30-33 weeks gestation
**2.5 mg/kg IV/IM q18h
**2.5mg/kg IV/IM q18h
**Alt 1: 3.5 mg/kg IV/IM q24hr
**Alt 1: 3.5mg/kg IV/IM q24hr
**Alt 2: 4.5 mg/kg IV/IM q36-48h
**Alt 2: 4.5mg/kg IV/IM q36-48h
*34 weeks gestation
*34 weeks gestation
**2.5 mg/kg IV/IM q18h
**2.5mg/kg IV/IM q18h
**Alt 1: 3.5 mg/kg IV/IM q24hr
**Alt 1: 3.5mg/kg IV/IM q24hr
**Alt 2: 4 mg/kg IV/IM q24-36h
**Alt 2: 4mg/kg IV/IM q24-36h
*35-36 weeks gestation
*35-36 weeks gestation
**2.5 mg/kg IV/IM q 12h
**2.5mg/kg IV/IM q 12h
**Alt 1: 3.5 mg/kg IV/IM q24
**Alt 1: 3.5mg/kg IV/IM q24
**Alt 2: 4 mg/kg IV/IM q24-36h
**Alt 2: 4mg/kg IV/IM q24-36h
*Full Term
*Full Term
**2.5 mg/kg IV/IM q12h
**2.5mg/kg IV/IM q12h
**Alt: 4 mg/kg IV/IM q24h
**Alt: 4mg/kg IV/IM q24h


===General (8 Days - 1 Month)===
===General (8 Days - 1 Month)===
*'''First Dose All: 2.5 mg/kg IV/IM x1'''
*'''First Dose All: 2.5mg/kg IV/IM x1'''
*<30 weeks gestation
*<30 weeks gestation
**2.5 mg/kg IV/IM q18h
**2.5mg/kg IV/IM q18h
**Alt: 4 mg/kg IV/IM q24-36h
**Alt: 4mg/kg IV/IM q24-36h
*30-33 weeks gestation
*30-33 weeks gestation
**2.5 mg/kg IV/IM q12h
**2.5mg/kg IV/IM q12h
**Alt: 4 mg/kg IV/IM q24
**Alt: 4mg/kg IV/IM q24
*34 weeks gestation
*34 weeks gestation
**2.5 mg/kg IV/IM q12h
**2.5mg/kg IV/IM q12h
**Alt: 4 mg/kg IV/IM q18h
**Alt: 4mg/kg IV/IM q18h
*35-36 weeks gestation
*35-36 weeks gestation
**2.5 mg/kg IV/IM q8h
**2.5mg/kg IV/IM q8h
**Alt: 4 mg/kg IV/IM q12h
**Alt: 4mg/kg IV/IM q12h
*Full term
*Full term
**2.5 mg/kg IV/IM q8h
**2.5mg/kg IV/IM q8h
**Alt: 4 mg/kg IV/IM q24h
**Alt: 4mg/kg IV/IM q24h
 
===General (1 Month -6 Months)===
*2.5mg/kg IV/IM q8h
*Alt: 6.5mg/kg IV/IM q24h
 
===General (>6 Months)===
*2.5mg/kg IV/IM
*Alt: 6.5-7.5mg/kg IV/IM q24h
*Use IBW if >2yo
 
 
===Indications by Disease===
{{#ask: [[Has DrugName::Gentamicin]] [[Has Population::Pediatric]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Special Populations==
==Special Populations==
*Pregnancy: D
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D
*Lactation: Probably safe
*Lactation: Probably safe
*Renal Dosing
*Renal Dosing
Línea 77: Línea 103:
****CrCl 10-50: give q12-48h
****CrCl 10-50: give q12-48h
****CrCl <10: give q48-72h
****CrCl <10: give q48-72h
****Hemodialysis: give 1-1.7 mg/kg after dialysis
****Hemodialysis: give 1-1.7mg/kg after dialysis
***Extended interval dosing
***Extended interval dosing
***CrCl 30-60: increase dosing interval based on levels
***CrCl 30-60: increase dosing interval based on levels
Línea 86: Línea 112:
****CrCl: 10-29: Give q18-24h
****CrCl: 10-29: Give q18-24h
****CrCl <10: give q48-72h
****CrCl <10: give q48-72h
****Hemodialysis/peritoneal dialysis: give 2 mg/kg after dialysis
****Hemodialysis/peritoneal dialysis: give 2mg/kg after dialysis
***Extended interval dosing
***Extended interval dosing
***CrCl 30-60: increase dosing interval based on levels
***CrCl 30-60: increase dosing interval based on levels
Línea 98: Línea 124:
==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Ototoxicity<ref>https://www.drugs.com/monograph/gentamicin-systemic.html</ref>
*Nephrotoxicity
*Prolongation of neuromuscular blockers


===Common===
===Common===
*Nausea/vomiting
*Irritation at injection site


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life:2-3 hours
*Metabolism:  
*Metabolism:  
*Excretion:  
*Excretion: Urine excretion
*Mechanism of Action:
*Mechanism of Action: Binds to 30S and 50S ribosomal subunits, disrupting mRNA translation and interfering with bacterial protein synthesis<ref>Chaves BJ, Tadi P. Gentamicin. [Updated 2022 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557550/</ref>
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||R
|-
| ||[[Strep. Pneumoniae]]||R
|-
| ||[[Viridans strep]]||X1
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||'''S'''
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||X1
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||R
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||'''S'''
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
|-
| ||[[Enterobacter]] sp, AmpC pos||'''S'''
|-
| ||[[Serratia]] sp||X1
|-
| ||Serratia marcescens||'''S'''
|-
| ||[[Salmonella]] sp||X1
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||X1
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||X1
|-
| ||[[Morganella sp.]]||X1
|-
| ||[[Citrobacter freundii]]||X1
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||X1
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||'''[[Has Antipseudomonal::S]]'''
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||'''S'''
|-
| ||[[Brucella sp.]]||''S+'''
|-
| ||[[Legionella sp.]]||X1
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||I
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||R
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||R
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||R
|-
| ||[[Clostridium difficile]]||R
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||R
|-
| ||[[Peptostreptococcus sp.]]||R
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
 
<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]]
[[Category:ID]]

Revisión actual - 11:07 20 mar 2026

General

  • Type: Aminoglycoside
  • Dosage Forms: IM; IV
  • Common Trade Names: Genticyn, Garamycin, Gentak

Adult Dosing

  • All: If obese, use Adjusted Weight = IBW + 0.4 x (ABW - IBW)
  • All: Adjust repeat dosing based on levels

General

  • Extended Interval
    • 5-7mg/kg IV q24h
    • First Dose: 5-7mg/kg IV
  • Conventional
    • 1-1.7mg/kg IM/IV q8h


Indications by Disease

DiseaseDoseContext
Acute cystitis3mg/kg/day divided q8hrInpatient
Cervicitis240 mg IM x 1GC/Chlamydia, CTX Contraindicated
Corneal abrasion0.3% solution 2 drops six times for 5 daysContact Lens
Endocarditis3mg/kg/day IV in 2 or 3 dosesNative Valve Endocarditis
Endocarditis3mg/kg/day IV in 2 or 3 dosesNative Valve Endocarditis, with Amoxicillin/Clavulanate
Endocarditis3mg/kg/day IV in 2 or 3 dosesMRSA Native Valve Endocarditis
Endocarditis3mg/kg/day IV in 2 or 3 dosesProsthetic Valve Endocarditis (Early)
Neisseria gonorrhoeae240mg IM x 1Uncomplicated Gonococcal
Pelvic inflammatory disease2mg/kg loading then 1.5mg/kg q8hr IVInpatient; combined with Clindamycin
Peritoneal dialysis-associated peritonitis0.6mg/kg dailyEmpiric IP
Plague5mg/kg IV/IM once daily x 10 daysActive disease
Postpartum endometritis5mg/kg IV q24hrs or 1.5mg/kg IV q8hrsCombined with Clindamycin; <48hrs postpartum
Prostatitis7mg/kg IV dailySeptic
Pyelonephritis3mg/kg/day divided q8hrAdult Inpatient
Tularemia5mg/kg/day IV/IM once daily x 10 daysActive disease
Urethritis in men240 mg IM x 1CTX Contraindicated

Pediatric Dosing

  • All: adjust repeat dosing based on levels

General (<8 Days Old)

  • First Dose All: 2.5mg/kg IV/IM x1
  • <28 weeks gestation
    • 2.5mg/kg IV/IM q24h
    • Alt: 5mg/kg IV/IM q48h
  • 28-29 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt: 5mg/kg IV/IM q48h
  • 30-33 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt 1: 3.5mg/kg IV/IM q24hr
    • Alt 2: 4.5mg/kg IV/IM q36-48h
  • 34 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt 1: 3.5mg/kg IV/IM q24hr
    • Alt 2: 4mg/kg IV/IM q24-36h
  • 35-36 weeks gestation
    • 2.5mg/kg IV/IM q 12h
    • Alt 1: 3.5mg/kg IV/IM q24
    • Alt 2: 4mg/kg IV/IM q24-36h
  • Full Term
    • 2.5mg/kg IV/IM q12h
    • Alt: 4mg/kg IV/IM q24h

General (8 Days - 1 Month)

  • First Dose All: 2.5mg/kg IV/IM x1
  • <30 weeks gestation
    • 2.5mg/kg IV/IM q18h
    • Alt: 4mg/kg IV/IM q24-36h
  • 30-33 weeks gestation
    • 2.5mg/kg IV/IM q12h
    • Alt: 4mg/kg IV/IM q24
  • 34 weeks gestation
    • 2.5mg/kg IV/IM q12h
    • Alt: 4mg/kg IV/IM q18h
  • 35-36 weeks gestation
    • 2.5mg/kg IV/IM q8h
    • Alt: 4mg/kg IV/IM q12h
  • Full term
    • 2.5mg/kg IV/IM q8h
    • Alt: 4mg/kg IV/IM q24h

General (1 Month -6 Months)

  • 2.5mg/kg IV/IM q8h
  • Alt: 6.5mg/kg IV/IM q24h

General (>6 Months)

  • 2.5mg/kg IV/IM
  • Alt: 6.5-7.5mg/kg IV/IM q24h
  • Use IBW if >2yo


Indications by Disease

DiseaseDoseContext
Acute cystitis2.5mg/kg IV q8hrsPediatric Inpatient
Endocarditis1mg/kg IV q8hrsPediatric Empiric
Pediatric fever of uncertain source4mg/kg/doseNeonatal 0-14 days with Ampicillin
Plague2.5mg/kg IV/IM q8hrs x 10 daysPediatric Active Disease
Pyelonephritis2.5mg/kg IV q8hrsPediatric Inpatient
Tularemia2.5mg/kg IV/IM q8hrs x 10 daysPediatric Active Disease

Special Populations

  • Pregnancy Rating: D
  • Lactation: Probably safe
  • Renal Dosing
    • Adult
      • Conventional interval dosing
        • CrCl 10-50: give q12-48h
        • CrCl <10: give q48-72h
        • Hemodialysis: give 1-1.7mg/kg after dialysis
      • Extended interval dosing
      • CrCl 30-60: increase dosing interval based on levels
      • CrCl <30: avoid use
    • Pediatric
      • Conventional interval dosing
        • CrCl 30-50: give q12-48h
        • CrCl: 10-29: Give q18-24h
        • CrCl <10: give q48-72h
        • Hemodialysis/peritoneal dialysis: give 2mg/kg after dialysis
      • Extended interval dosing
      • CrCl 30-60: increase dosing interval based on levels
      • CrCl <30: avoid use
  • Hepatic Dosing (Adult & Pediatric)
    • Not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Ototoxicity[1]
  • Nephrotoxicity
  • Prolongation of neuromuscular blockers

Common

  • Nausea/vomiting
  • Irritation at injection site

Pharmacology

  • Half-life:2-3 hours
  • Metabolism:
  • Excretion: Urine excretion
  • Mechanism of Action: Binds to 30S and 50S ribosomal subunits, disrupting mRNA translation and interfering with bacterial protein synthesis[2]

Antibiotic Sensitivities[3]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G R
Strep. Pneumoniae R
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis S
Enterococcus faecium S
MSSA S
MRSA R
CA-MRSA X1
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae R
N. meningitidis R
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ S
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp X1
Serratia marcescens S
Salmonella sp X1
Shigella sp S
Proteus mirabilis X1
Proteus vulgaris S
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa S
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica S
Francisella tularensis S
Brucella sp. S+'
Legionella sp. X1
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus I
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp R
Mycobacterium avium X1
Anaerobes Actinomyces R
Bacteroides fragilis R
Prevotella melaninogenica R
Clostridium difficile R
Clostridium (not difficile) X1
Fusobacterium necrophorum R
Peptostreptococcus sp. R

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ https://www.drugs.com/monograph/gentamicin-systemic.html
  2. ↑ Chaves BJ, Tadi P. Gentamicin. [Updated 2022 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557550/
  3. ↑ Sanford Guide to Antimicrobial Therapy 2014
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