GENTAMICIN

Broad spectrum aminoglycoside antibacterial

Dosage Forms

Injection

40 mg/ml in 2 ml vial

Solution for Eye/Ear Drops

0.3%

Uses

  • Brucellosis
  • Neonatal meningitis
  • Neonatal sepsis
  • Endocarditis
  • Plague
  • Septicaemia
  • Severe pneumonia
  • Acute kidney infection
  • Surgical prophylaxis
  • Eye infection (blepharitis, bacterial conjunctivitis)
  • Ear infection (topical use)

Dose and Duration

Brucellosis (in combination with doxycycline)
Adult: 5–7 mg/kg IV once daily for 14 days
Child <8 years: 7.5 mg/kg daily in 1–3 divided doses for 14 days
Neonatal meningitis, neonatal sepsis (in combination with ampicillin or benzylpenicillin)
2.5 mg/kg IV every 12 hours for 21 days
Plague
1.7 mg/kg IV or IM every 8 hours for 7 days
Septicaemia (in combination with cloxacillin or ceftriaxone or benzylpenicillin or chloramphenicol)
Adult: 1.5–2 mg/kg IV or IM every 8 hours for 14 days
Child: 3.5–4 mg/kg IV every 8 hours for 14 days
Neonate: 3.5–4 mg/kg every 8–12 hours for 14 days
Severe pneumonia, endocarditis (first line treatment; in combination with ampicillin)
Adult: 5–7 mg/kg IV daily in 1–2 divided doses for 5 days
Child >7 days: 2.5 mg/kg IV every 8 hours for 5–10 days
Child <7 days: 2.5 mg/kg IV every 12 hours for 5–10 days
In moderate pneumonia, give for 7 days
In very severe pneumonia, give for 10 days
Surgical prophylaxis
Adult: 1.5 mg/kg by slow IV injection over 3 minutes, at least 30 minutes before procedure
Acute kidney infection
Adult: 5–7 mg/kg IV daily in 2–3 doses
Child: 2.5 mg/kg every 8 hours for 7 days
Eye or ear infection
Apply 1 drop every 2 hours, and then reduce frequency as infection is controlled. Continue for up to 48 hours after healing is complete.
In severe infection, apply 1 drop every hour.

Contraindications

  • Allergy to gentamicin or streptomycin
  • Severe kidney disease
  • Severe hearing problems

Side Effects

  • Kidney disease
  • Hearing problems
  • Nausea, vomiting
  • Rash
  • Local irritation with eye drops

Interactions

  • Streptomycin (increased risk of side effects)
  • Furosemide (increased risk of side effects)

Patient Instructions

  • Report immediately to health worker if any hearing problems or reduced urinary output occur

Pregnancy

  • Do not use

Breast-feeding

  • Can be used

⚠️ Caution

  • Reduce dose in kidney disease to 1 mg/kg/day or increase the dosing interval
  • Give with caution to the elderly; daily dose usually given in two doses to minimise side effects
  • Avoid prolonging treatment unnecessarily; whenever possible, do not exceed 7 days
  • In obese patients use ideal (not actual) body weight to calculate dose
  • Doxycycline is the first line for plague
  • Prolonged use for eye infections may cause skin sensitisation and emergence of resistant organism including fungi; discontinue if there is purulent discharge, inflammation or exacerbation of pain