Gentamicin Sulfate(jen ta mye’ sin)
Parenteral intrathecal: Alcomicin (CAN), Pediatric Gentamicin Sulfate
Ophthalmic: Gentak
PREGNANCY CATEGORY D
PREGNANCY CATEGORY C
(OPHTHALMIC)
Drug class
Aminoglycoside
Therapeutic Actions
Bactericidal: Inhibits protein synthesis in susceptible strains of gram-negative bacteria; appears to disrupt functional integrity of bacterial cell membrane, causing cell death.
Indications
Parenteral
Treatment of serious infections caused by susceptible strains of Pseudomonas aeruginosa, Proteus species, Escherichia coli, Klebsiella-Enterobacter-Serratia species, Citrobacter, Staphylococcus species
Treatment of serious infections when causative organisms are not known (often in conjunction with a penicillin or cephalosporin)
Unlabeled use: With clindamycin as alternative regimen in PID
Intrathecal
Treatment of gram-negative infections
Treatment of serious CNS infections, such as meningitis, ventriculitis, infections caused by susceptible Pseudomonas species
Ophthalmic preparations
Treatment of superficial ocular infections due to strains of microorganisms susceptible to gentamicin
Topical dermatologic preparation
Infection prophylaxis in minor skin abrasions and treatment of superficial infections of the skin due to susceptible organisms amenable to local treatment
Contraindications and Cautions
Contraindicated with allergy to any aminoglycosides.
Use cautiously with renal or hepatic disease; sulfite sensitivity; pre-existing hearing loss; active infection with herpes, vaccinia, varicella, fungal infections, mycobacterial infections (ophthalmic preparations); myasthenia gravis; parkinsonism; infant botulism; burn patients; lactation, pregnancy.
Available Forms
Injection—10, 40 mg/mL; injection in 0.9% sodium chloride—0.6, 0.8, 0.9, 1, 1.2, 1.4, 1.6 mg/mL; ophthalmic solution—3 mg/mL; ophthalmic ointment—3 mg/g; topical ointment—0.1%; topical cream—0.1%; ointment—1 mg; cream—1 mg
Dosages
Dosage should be based on estimated lean body mass, or adjusted body weight if patient is morbidly obese.
Parenteral
Adults
3 mg/kg/day in three equal doses every 8 hr IM or IV. Up to 5 mg/kg/day in three to four equal doses in life-threatening infections, usually for 7–10 days. For IV use, a loading dose of 1–2 mg/kg may be infused over 30–60 min. Once daily/extended interval dosing: 5–7 mg/kg/day.
PID: 2 mg/kg IV followed by 1.5 mg/kg tid plus clindamycin 600 mg IV qid. Continue for at least 4 days and at least 48 hr after patient improves, then continue clindamycin 450 mg orally qid for 10–14 days total therapy.
Surgical prophylaxis regimens: Several complex, multidrug prophylaxis regimens are available for preoperative use; consult manufacturer’s instructions.
Pediatric patients
2–2.5 mg/kg every 8 hr IM or IV.
Infants and neonates: 2.5 mg/kg every 8 hr.
Preterm or full-term neonates 1 wk or younger: 2.5 mg/kg every 12 hr.
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